Birth control and blood clots

[tonasa94]

Hi,

So, I'm having a lot of anxiety about birth control pills and blood clots. I was on Yasmin for 5 months, went off it for a bit, and am now supposed to be starting Sprintec. I didn't have any warning symptoms or bad experience with blood clots during those 5 months.

But, when I went for the prescription, my NP asked about family history of blood clots, which was not something my first provider asked about, and I mentioned that my mom had a bad case of one in her lung while pregnant. At the time, she was over 40, overweight, sedentary, and 7 months pregnant. The doctors in her case eventually concluded that it was most likely all of these physical factors which led to her blood clot, not genetic ones. The NP said I would most likely be fine on a combined pill, as I'm a young, fairly healthy, lightly active, non-smoker. She prescribed me Sprintec, which I'm supposed to start taking when I get my next period.

However, I can't get the anxiety about blood clots out of my head. I know I was fine when I took the Yasmin for 5 months, but I've heard so many horror stories of young women having severe issues and even dying while taking the combined BCP due to blood cots. I have good knowledge of how scary a blood clot can be for someone. I can't get the thought of me having a blood clot while I sleep out of my head.

I want to be protected from pregnancy and have better periods, both things which hormonal birth control offers. I can't really afford a method other than a generic pill, as I have to pay out of pocket to avoid my using birth control being found out by my parents. Talking to them isn't an option, my mom is morally against any form of birth control that is not 100% exclusively fertility-awareness based (no backup methods, just abstinence) and also premarital sex. She also believes hormonal birth control is responsible for breast cancer increases, weight gain, and other side effects and doesn't believe it should even be used for period control.

I don't feel comfortable using just condoms for pregnancy prevention, but I also don't want to avoid intercourse when I see my long-distance boyfriend soon in what will be our first visit in months.

[Sam W]

Hi tonasa,

I'm sorry you've been having these worries. I think the best thing to focus on is that the doctor, who had information about your medical history, proscribed these pills, and likely would not have done so if they thought you were at any realistic risk for blood clots.

You mention needing to pay out of pocket for birth control. Is there a long range method (like the IUD or implant) that you could save up for and would prefer over the pill, since you'd only need to pay for it once every few years?

[Amanda]

To add to what Sam said, blood clots are probably not a big concern for you, as your doctor mentioned (although you should feel free to seek a second opinion). They are mainly a concern for people with high blood pressure, high cholesterol, those over 35, people with clotting disorders and smokers. The risk of developing a blood clot is actually much higher during pregnancy than it is for people taking birth control pills. There are always going to be the outliers: the horror stories we hear (sometimes true, often half-true) of people who have severe health issues, sometimes related to medications. But it's not sound to make decisions and asses risk based on these stories. It's best to look at reliable sources, with data that includes large groups and accounts for multiple factors and variables.

Regarding your mom's concerns: in large, population-wide studies, birth control pills have been shown to decrease risk of certain cancers and increase risk of others, one of which is breast cancer. However, not enough research exists for women who have come of age using newer, lower-dose pills which likely have little to no effect on cancer risk-- the main culprit is thought to be high-dose pills, which very few people take these days. The idea that birth control pills cause weight gain is largely a myth. Initially, those who take birth control pills may experience a few pounds of weight gain--water retention or "water weight"--but this typically goes away after a couple of months. Again, the belief probably stems from the side effects of the older high-dose pills, which likely did cause weight gain.

Ask your doctor about any other questions or concerns you have, and perhaps consider, like Sam mentioned, exploring some other birth control options, some of which are very reliable and long-term and do not involve hormones. You can do that here: Birth Control Bingo!