Blood Clots and Combined Hormonal Contraception - The Pill, Patch & Ring
Estrogen affects the natural blood clotting mechanism in your body. This is why there is an increased risk of blood clots, and all those other really bad reactions, when people talk about taking hormonal birth control.
Women have risks due to pregnancy, birth control and postmenopausal hormone therapy that men do not. These risks are generally attributed to estrogen, a key ingredient in birth control pills, patches, and rings, and in postmenopausal hormone therapy.
Estrogen does not cause blood clots, but it does increase the risk by several-fold. All hormonal birth control, with added estrogen, carries a risk of blood clots. In the 1960s, the estrogen used in the earliest pills raised the risk of clots more than nine-fold. A decade later, a second generation of pills containing a much gentler dose of the hormone, coupled with the synthetic hormone progestin, had been developed.
Though these second-generation pills are effective and safe, drug makers have sought new forms to market as better able to control conditions like facial hair and acne. NuvaRing contains a version of the third-generation progestin desogestrel. There's even a fourth-generation progestin, said to alleviate symptoms of PMS; it's the essential component of Yaz and Yasmin, two top-selling oral contraceptives, but it is clearly a dangerous and risky drug.
The problem? Most researchers say third- and fourth-generation contraceptives raise the risk of blood clots without adding any benefit.
In 2007, the consumer watchdog group, Public Citizen, petitioned the FDA to ban oral contraceptives containing desogestrel. Although NuvaRing wasn't named in that petition because it was still fairly new, the director of Public Citizen's Health Resource Group, Dr. Sidney Wolfe, reached an unequivocal conclusion "We've told people not to use these drugs and have advised women that the safest hormonal contraceptives are the older, second-generation ones." The FDA didn't act on Public Citizen's claims, even though during its own review process, the agency concluded that NuvaRing's label should "clearly reflect safety concerns about an increased risk" for blood clots.
In 2009, the British Medical Journal published two investigations of desogestrel and fourth-generation progestins that seemed to bolster critics' concerns. Both studies found that women taking third- and fourth-generation pills were almost twice as likely to get a blood clot than those who took second-generation contraceptives. Frits Rosendaal, Ph.D., an epidemiologist at Leiden University Medical Center in the Netherlands who has contributed to more than a dozen scientific papers on desogestrel, coauthored one of the studies that found a higher risk for clots in NuvaRing than in second-generation birth control. "To me, it's incredible that [Merck] used desogestrel and not a second-generation progestin. Why not go for the one with the lowest risk?" says Rosendaal.
What Is Deep Vein Thrombosis - why should I care?
Deep vein thrombosis (DVT) is a blood clot that develops in the deep and larger veins in one or both legs, usually in the lower leg (figure shows DVT in the left thigh). DVTs can be dangerous because the clot may become large, break apart, and go through the blood vessels and lodge in the lungs, resulting in decreased or no blood flow to the lungs. This situation may lead to rapid organ damage and even death.
What is a Pulmonary Embolism - why should I care?
Pulmonary embolism (PULL-mun-ary EM-bo-lizm), or PE, is a sudden blockage in a lung artery. The blockage usually is caused by a blood clot that travels to the lung from a vein in the leg.
A clot that forms in one part of the body and travels in the bloodstream to another part of the body is called an embolus (EM-bo-lus).
PE is a serious condition that can:
Damage part of your lung because of a lack of blood flow to your lung tissue. This damage may lead to pulmonary hypertension (increased pressure in the pulmonary arteries).
Cause low oxygen levels in your blood.
Damage other organs in your body because of a lack of oxygen.
If a blood clot is large, or if there are many clots, PE can cause death.
Why Blood Clots Are Dangerous
17 year old Dies Due To a Massive Blood Clot - Yaz Pill
How "The Pill" Gave Me a Blood Clot
My Experience with a Pulmonary Embolism
The Basics of Blood Clots - What You Need to Know
Deep Vein Thrombosis/DVT and Pulmonary Embolism/PE