Verbatim response from Claude
It depends, but here are some honest recommendations:
Proceed with Caution
High blood pressure is an important factor because estrogen-containing birth control (like combined pills) can raise blood pressure further and increase stroke/clot risk. Telehealth services will ask about this.
Services That Handle This Well
- Wisp - Specifically screens for blood pressure concerns and may recommend progestin-only options
- Nurx - Has nurse practitioners who can navigate complex health histories; they'll likely recommend a mini-pill (progestin-only) or non-hormonal options
- Planned Parenthood Direct - Good clinical protocols for flagging contraindications
What to Expect
Most services will:
- Ask your blood pressure numbers
- Avoid prescribing combined estrogen/progestin pills if your BP is elevated
- Possibly recommend progestin-only pills, IUDs, or implants instead
- May refer you to an in-person provider if your BP is significantly high
When to Go In-Person Instead
If your blood pressure is consistently above 140/90, an in-person visit is safer so a provider can take your BP directly and monitor you.
Bottom line: These services can work, but be completely honest about your numbers — they'll adjust the recommendation accordingly.