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In some women, the
estrogen in combination hormonal
birth control methods increases the risk of a blood
clot in a leg (deep vein thrombosis, or DVT) or a blood clot in a
lung (pulmonary embolism, or PE). A blood clot in a leg vein
can travel through the circulation system and cause pulmonary embolism.
The risk for DVT or PE is overall very low with hormonal contraceptives.
In the past, combination birth control pills contained a higher dose of
estrogen, which increased the risk of DVT and PE. Now the combination pill
contains a lower dose of estrogen, and the risk is reduced. The risk for DVT or
PE is actually higher for a pregnant women than for nonpregnant women taking
Combination hormonal birth control pills that
progestin called desogestrel increase the risk of blood clots more than birth control pills that contain other types of progestin.1 The progestin called drospirenone (found in pills such as YAZ or Yasmin) also might have a greater risk of blood clots than other types of progestin.2 Talk to your doctor about the risk of blood clots when deciding which pill is right for you.
The birth control patch delivers more estrogen than the
low-dose birth control pills do. The U.S. Food and Drug Administration (FDA)
warns that women using the patch are slightly more likely to get dangerous
blood clots in the legs and lungs than women using birth control pills. So talk
to your doctor about your risks before using the patch.
risk factors for blood clots (DVT or PE) include:3
Studies have shown that
high blood pressure,
diabetes, and superficial
varicose veins do not increase
the risk for blood clots.3
Abramowicz M (2010). Choice of contraceptives. Treatment Guidelines From the Medical Letter, 8(100): 89–96.
U.S. Food and Drug Administration (2011). FDA Drug Safety Communication: Updated information about the risk of blood clots in women taking birth control pills containing drospirenone.
Available online: http://www.fda.gov/Drugs/DrugSafety/ucm299305.htm.
American College of Obstetricians and Gynecologists (2006, reaffirmed 2008). Use of hormonal contraception in women with coexisting medical conditions. ACOG Practice Bulletin No. 73. Obstetrics and Gynecology, 107(6): 1453–1472.
May 3, 2012
Sarah Marshall, MD - Family Medicine & Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
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