The interplay between hormonal contraceptive use, mental health, and cardiovascular risk in women remains poorly understood, particularly in the context of stress-related psychiatric disorders. In this large retrospective cohort study of 31,824 women aged 18–55 years, combined hormonal contraceptive use was examined in relation to major adverse cardiovascular events (MACE) and deep-vein thrombosis, stratified by the presence of depression, anxiety, or posttraumatic stress disorder (PTSD).
Hormonal contraceptive use was associated with lower odds of MACE irrespective of a history of depression or anxiety, with no evidence that these conditions modified cardiovascular or thrombotic risk. In contrast, PTSD emerged as a key modifier: contraceptive use was associated with lower cardiovascular risk only among women without PTSD, while this protective association was absent in women with PTSD.…
