Pills give young women an increased risk of blood clots.
Blood value reveals risk of blood clot
– I had been on my pill for two months before I started to notice that I was stumbling in the thigh and buttocks. This was at the very beginning so it was not something I thought so much more before the pain began to creep longer up.
Four years ago, Marie Vigebo, who was 17 years old, woke up breathing.
– I did not get the breath properly and it was stuck in my chest. I knew something was wrong, but I never knew that the pills could be the reason, “says Marie.
Failed to go to bus
She chose to go to the doctor only when she later felt she began hyperventilating. At the first visit, no direct cause of Marie’s pain was found.
When she knew another morning a while later, she took two paracets and went to school.
– I remember that I had to sit in special positions, go very calmly, move me a bit and think about each time I breathed because it hurt my chest, or the “heart” that I said. When I got home from school, I had to ask dad to pick me up because I failed to go to the bus.
Marie’s father drove to the doctor where she was then sent straight to the hospital emergency room. Many blood samples, X-rays and a MRI were taken.
Then came the result. Both lungs were full of blood clots.
– The doctor told me that the blood clots probably had started in my legs and still up against the lungs and that’s why I was so bad in my thigh for a long time, says 21-year-old.
The doctor also said that if Marie had not come over the next few days, she probably could die.
Marie was admitted to hospital and was on cardiac monitoring the same night.
– I was very scared. Mostly because I was unaware and had not had enough information about what it would say to have a blood clot, how to get it and what would happen.
Marie was in hospital for two days before she was sent home with blood thinning medicines and strong painkillers.
She was told to contact again if the pain became worse.
And they became.
– I’ve never been so bad before. The pain I felt in my chest I do not treat anyone. Every breath was felt like a knife stab in the lungs, I could not eat, drink, move, sleep, stand, sit – absolutely everything hurts, explains the 21-year-old.
After a few days, they called the hospital and asked for a stronger pain reliever and an extra check.
– I remember going from the car in the parking lot and into the hospital, just a few meters. I went bent over my upper body, with my head on my chest while the tears ran out of pain. I have never felt worse throughout my life, she says.
Marie got stronger painkillers, saying it had not gotten any worse, and that she just had to adhere to the blood thinning medicines began to work.
She went on medicine for six months. Then she was again checked at the hospital.
– It turned out that the lungs were clean again, fortunately!
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– Healthcare and physician should always ask
Marie feels she was not well informed about the risk of blood clots when she received birth control pills by health sister.
Signs of blood clot
Blood clot in joint vein (vein)
Most blood clots occur in joint veins in the legs or arms.
- One leg / thigh swings, weight sensation, redness and / or pain in the leg.
- It is also common for you to get a little light fever.
Blood clot in the lung (pulmonary embolism)
Blood clots in the leg or arm can loosen and flow with the bloodstream to the lungs.
- Suddenly powerful cough with or without bloody splash, without cause.
- Chest pain and sudden breathing difficulties, especially if you breathe hard.
In very rare cases, blood clots may also occur in pulse ulcers.
– If you think you may have a blood clot, consult a doctor or emergency department.
(Sources: Chief Sigrud Hortemo and researcher Sigrid Brækkan. )
– We recommend that more women consider long-acting contraceptives such as hormone spikes or p-sticks. These only contain progestogen and do not increase the risk of blood clots. In addition, long-acting contraception provides better protection against pregnancy than pills that are easy to forget.
– If the woman wants a pill, the mini-pill Cerazette is a good option for many. This only contains progestogen and does not increase the risk of blood clots. The downside is that minipiller more often causes irregular bleeding than estrogen contraceptives.
– Many young people are concerned with good bleeding control and want the opportunity to skip a bleeding. Then the estrogen combination pill is applicable.
– When the woman wants a combination pill, we recommend that everyone starts with a pill of estrogen and levonorgestrel (Loette, Microgynon or Oralcon) since they provide at least increased risk of blood clots.
(Information from Sigurd Hortemo, general practitioner at the Norwegian Medicines Agency. )
Sigurd Hortemo, general practitioner at the Norwegian National Agency for Medicines, finds it to be hoped that girls will get birth control pills without getting enough information about the risk of blood clots.
– Our impression, however, is that health sisters are as good as doctors to inform about this. If there is doubt that a girl should get hormonal contraception, the healthcare provider should always refer to a doctor’s assessment, “Hortemo says..
The superior states that there are some hereditary conditions that increase the risk of blood clots.
– The doctor or healthcare provider should always ask if there have been cases of blood clots in close family. In such cases, we do not recommend contraception with estrogen, he says.
Hortemo believes it is important that safe contraception is readily available.
– We have therefore recently expanded the scheme so that health sisters can now write a prescription on all types of hormonal contraception – including hormone spiral and p-sticks, he says..
Estrogen contraception increases risk
According to Hortemo, only birth control contains estrogen that increases the risk of blood clots. This applies to combination birth control pills, p-rings and p-plastics. Contraception containing only progestogen does not give rise to increased risk. This applies to minipille, hormone coil, p-rod and p-syringe.
– If the woman wants to start with a combination pill, we recommend starting with a pill of estrogen and levonorgestrel, such as Loette, Microgynon or Oralcon, as these cause the least risk of blood clotting, “he says..
Hortemo recommends women to start with one of the pills that gives the least risk of blood clots – or switch to another if the woman does not like the first.
Sigrid Brækkan, researcher at K. G. Jebsen Center for Thrombosis Research at the University of Tromsø, states that the risk of blood clots is increased 3-4 times by birth control.
– Basically, blood clot risk is very low in young women. It is also worth noting that pregnancy is associated with a greater risk of blood clots than pills, “says Brækken.
Biggest is the risk of blood clots during the first 6-12 months after starting with a new combination pill, according to Hortemo.
She believes it is important to follow these tips:
- Use your pill and avoid unnecessary breaks.
- If you are satisfied with the pill you are using, you should not constantly change the mark.
- Do not borrow contraceptives by others.
- If you smoke, stop it.
- Talk to your doctor or healthcare sister if you’re wondering.
As Hortemo, Brækkan emphasizes that women who are hereditary are more likely to have blood clots.
– So if you have a father, mom sister or brother who has had a blood clot, use of pill is advised. It is also unfavorable to use birth control pills if you are overweight with BMI over 30, says the researcher..
According to Brækkan, the risk of relapse is low in women with birth control pills as the sole cause of blood clots, provided that they stop taking birth control pills.
Women are advised not to use contraceptive pills if they have had a blood clot, she warns.
The breach emphasizes that research on the risk of blood clots is still being investigated due to birth control.
– In particular, to investigate the interaction between birth control and other risk factors that can help identify those women at extra high risk. Part of the mechanisms behind the relationship between birth control and blood clot formation are also being investigated, the researcher continues.
Fears it can happen again
Marie was told to quit contraceptives and that she could never use contraception with estrogen again.
– The safest option for me in my situation, I’ve been told is copper spiral, she says.
The doctor informed her that she has an increased risk of getting a blood clot again.
– Since I never want to use birth control pills, there is a chance of low blood clots. However, I have to be careful about other medicines, medicines and situations where blood clots are a danger, “said 21-year-old..
Marie feels lucky today.
According to Hortemo, extensive research is being done to monitor the risk of blood clots when using birth control pills.
– Recently, the European Medicines Agency made a thorough assessment of all available knowledge about this, says superior.
The table shows the number of blood clots that will occur in 10,000 young women over a year:
Fresh women who do not use birth control pills
Minipiller (like Cerazette and Conludag)
Estrogen and levonorgestrel birth control pills (like Loette, Oralcon, Microgynon)
Estrogen and Noretisterone birth control pills (as Synfase)
Pills with estrogen and drospirenone (like Yasmin, Yasminelle and Yaz)
Estrogen and desogestrel birth control pills (like Marvelon and Mercilon)
P-patches and p-rings (like Evra and Present)
Pills with estrogen and dienogest (like Qlaira)
Exact risk not known
Pills with estrogen and nomegestrol (like Zoely)
Exact risk not known
Nevertheless, I still sit with a little fear that it will happen again, and notice that I quickly get scared if I feel minor symptoms of the same type of pain, she admits.
– Grateful for the help
Marie believes it’s too easy for young people to get birth control without knowing if the body can withstand it.
– I think health sisters should refer to the GP to print out oral contraceptive pill. There may be illnesses or other health reasons in the family that can help change the type of birth control or brand that suits each individual, says 21-year-olds and continues:
When health sisters can print a prescription on birth control pills without the consent of a doctor, it should be a hundred percent sure each of them asks if someone in close relatives has had a blood clot earlier, says Marie.
Blood clots are in close family with Marie. Had she known about the risk this causes, she probably had chosen differently and never been affected by blood clots, she believes.
Marie is also grateful for the help she received from the healthcare staff.
– I feel that I became, and still gets, taken seriously, even when I go to the doctor and just want to check me to be sure.
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