ReviewInternational journal of women's health2026
Cardiometabolic, Glycaemic, and Metabolic Safety of Hormonal Contraceptives in Women with Medical Conditions: A Systematic Review.
Review in International journal of women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
7 authors.
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Abstract
Background: Hormonal contraceptives are widely used, however, their safety among women with underlying medical conditions, particularly cardiometabolic disorders such as hypertension, diabetes mellitus, and obesity, remains a key clinical concern. As the prevalence of these conditions increases globally among women of reproductive age, updated evidence is required to support risk-stratified contraceptive decision-making. Objective: To evaluate the cardiometabolic, glycaemic, and metabolic safety of hormonal contraceptive use among women with underlying medical conditions. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Web of Science, and Scopus were searched for English-language human studies published between 2015 and 2025. Eligible studies included randomized controlled trials, cohort studies, case-control studies, and comparative observational designs. Data were synthesized descriptively due to heterogeneity in study populations, exposure characteristics, and outcome measures. Methodological limitations included English-language restriction, lack of protocol registration, and inconsistent reporting of contraceptive dose, formulation, and duration. Results: A total of 44 studies were included, with combined estrogen-containing contraceptives being the most frequently evaluated (79.5%, 35/44). Progestin-only methods 18.2% (8/44); long-acting reversible contraceptives 18.2% (8/44); mixed hormonal exposure 13.6% (6/44). Hypertension was the most commonly reported comorbidity, followed by diabetes mellitus and obesity. Lipid and metabolic parameters were reported in 31.8% (14/44) of studies, blood pressure outcomes in 25.0% (11/44), and glycaemic outcomes in 15.9% (7/44). No notable short-term changes were observed however, modest increases in systolic blood pressure, triglycerides, and insulin resistance were identified in selected high-risk populations. Conclusion: Hormonal contraceptive use shows no consistent short-term cardiometabolic risk; however, modest adverse changes in high-risk populations requires risk-stratified use and further standardized longitudinal research.
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