Comment on "Contraception Use in Adolescents and Young Adults with Congenital Heart Disease".

Contraceptive use among adolescents and young adults with congenital heart disease (CHD) is notably lower, influenced by multiple critical factors. This critique highlights three key determinants that warrant further investigation in future research. First, studies indicate that hormonal contraceptives, particularly estrogen-containing methods, may elevate the risk of thromboembolic complications, arrhythmias, and heart failure in CHD patients, especially those with Fontan circulation or transposition of the great arteries. Second, menstrual irregularities are prevalent among CHD patients, with a significant proportion facing contraindications to estrogen-based contraceptives, potentially discouraging their use. Lastly, inadequate disease-specific contraceptive counseling contributes to knowledge gaps, limiting informed decision-making regarding reproductive health. Addressing these determinants is essential to optimize contraceptive use and improve reproductive health outcomes in CHD patients.