Among the side effects of hormonal birth control that have made news in recent years is the increased risk of blood clots, which are painful, dangerous, and at times fatal. How serious is this concern? Everyone’s got an opinion.
Bad News for Anyone
The fact of the matter is that blood clots are bad news, whether they’re caused by genetics, being limited in movement for a period of time, or as the side effect of a medication. When a clot forms in a deep vein, the resulting condition, deep vein thrombosis (DVT), can cause swelling, pain, and ulcers. If part of the clot breaks off and travels to a lung, it can cause a blockage called a pulmonary embolism (PE), which can prevent blood from reaching the lungs. Those who have experienced DVT or PE are at increased risk of developing another blood clot in the future.
Data shows that contraceptive drugs increase the risk of blood clot. Proponents for hormonal birth control argue that it was a small risk to start with (between 1 and 5 of every 10,000 women), and the increase isn’t drastic (between 3 and 9 of every 10,000). Every medicine has its side effects, they say. Read: there are not enough women dying each year to call for a change.
While many medical professionals may think the health risks of birth control are worth it to help a woman avoid pregnancy, it’s doubtful she’ll feel liberated if she’s in the ICU for two weeks, suffers debilitating pain, has to be on blood thinner for the rest of her life, or isn’t able to conceive in the future. Even when clots aren’t fatal, they provide considerable damage to women’s health and freedom.
Apples to Oranges
Some compare the risk of blood clots while on birth control to that while pregnant or postpartum. They correctly note that the natural increase in estrogen during pregnancy and the postpartum period is much greater, and thus the risk of blood clots is much more elevated (between 5 and 20 of every 10,000 pregnant women, and 40 to 65 of every 10,000 postpartum women), than the rise in estrogen and consequential rise in risk from HBC use. It’s odd to compare the risks of birth control to risks inherent in pregnancy, considering one is a natural physical process and one is the side effect of a drug.
Most forms of hormonal birth control have been shown to increase the risk of blood clots—especially those that contain estrogen or certain types of progestin. And these are among the most popular. They include the Pill, Beyaz, Yasmin, Yaz, NuvaRing, Xulane, and Nexplanon. Disappointingly, the American College of Obstetricians and Gynecologists makes just this apples-to- oranges comparison, minimizing the increased risk of blood clots in HBC users, especially HBC that contains drospirenone (as in Yasmin and Yaz), in comparison to rates during pregnancy or the postpartum period, without mention of the known maternal health benefits of pregnancy or of the facts that HBC does not solve any reproductive issue and isn’t the only way to effectively prevent pregnancy.
First Do No Harm
Women looking to avoid pregnancy need not take on additional risks to their health. The reality is that even though the risk of a blood clot is relatively low, women have died and continue to die because of their hormonal birth control. We remember in 2013 the tragic death of Erika Langhart, whose life was cut short by a double massive pulmonary embolism as a result of taking the NuvaRing. It was true then as it is now: pharmaceutical companies try to minimize these deaths and health risks.
The good news is that there are other healthier options for women looking to avoid pregnancy. Fertility Awareness-Based Methods (FABM) have similar effectiveness rates of avoiding pregnancy as hormonal birth control. And FABMs, also known as Natural Family Planning (NFP), don’t have the side effects of hormonal birth control, because they are based on understanding and honoring a woman’s body, rather than manipulating it. With the guidance of a FABM-trained instructor, charting one’s cycle can even help identify and remedy certain medical conditions, rather than creating new ones.
When we asked men why they chose to use FABMs, one man cited his wife’s health as a priority in their decision: “Other birth control methods can inflict harm on your wife,” he said. “[Oral contraceptive pills] are associated with thromboembolic events [blood clots], so NFP is the safest way to go.”
In any medical decision, safety ought to be a key deciding factor, and every woman should have the complete information she needs to make a decision in her best interest, to best reach her health and family-planning goals.
