Thrombosis risk and the pill: the underestimated danger

For a few days already Karolin felt the Pain in the leg, "It was such a funny move, deep inside," she says. Her doctor taps sore muscles. However, Karolin feels already a bit struck there, Namely, shortly after she started to take the pill two months ago. Against her kidney pain she receives an antibiotic because the doctors suspect a bladder infection.

The then 17-year-old is an exchange student in Denmark. She does not want to be a burden to her host family and therefore plays down the discomfort in her leg. But when she suddenly runs out of school in the morning, her friend makes sure she gets to the hospital.



There it turns out: Karolin has neither cystitis nor sore muscles, but a severe thrombosis. The deep vein in the right leg is closed, from the ankle to the renal pelvis. Karolin is just in time. Some blood clots have made their way to their lungs and clog them up. This can quickly become life-threatening.

The pill increases the risk of thrombosis

Karolin was lucky: Every year around 100,000 people in Germany die as a result of thrombosis or pulmonary embolism, a small part of them young women. Because the disease is not an old people's suffering. However, thrombosis is often recognized very late, especially in younger people because, as in the case of karolin, it often causes little or very different symptoms at first.



In mathematical terms, is the risk low? only two out of every 10,000 women fall ill within a year ?, but certain factors increase the risk: obesity and smoking, for example? and hormonal contraception. About five to seven out of every 10,000 women who take the pill suffer thrombosis, the contraceptive ring has a similar probability. For the newer pills, the rate doubles up to 14 out of 10,000

An inborn clotting disorder increases the risk

Often overlooked is still another risk factor. By a congenital blood clotting disorder namely, the probability of thrombosis increases tenfold. When Karolin is examined in the hospital, it turns out: Your risk is even a hundredfold with the pill. Because she has one so-called factor V Leiden mutation inherited from both parents. Since a gene on the coagulation factor V is changed, the blood clots easier and form faster blood clots, so-called thrombi, Everything about thrombosis signs and thrombosis in the arm you will find out here.



Such mutations can be the reason for thrombosis in families. And are not that rare: "Almost ten percent of all women of childbearing age have an inherited tendency to thrombosis without knowing it"says Frankfurt professor Edelgard Lindho-Last, a specialist in coagulation disorders. Whether someone is the carrier of such mutations, can be through genetic tests prove.

But should she really let everyone do it? "A general screening, so a test for all young women, I do not think it makes sense," said gynecologist Professor Ludwig Kiesel of the University of Münster. He demands, however, that gynecologists specifically and extensively ask for thrombosis in the family before prescribing the pill. This is still far too little, says Lindho-Last: "In my lecture hall only every second student reports that her gynecologist wanted to know if there were thromboses in the family."

Are there alternatives to the pill?

The best prevention: Generally, the pill should be prescribed with the lowest risk. Namely the the second generation, with levonorgestrel, "I find it completely incomprehensible that this does not happen," says the expert. She explains that the pharmaceutical industry brings new contraceptive pills to the market every year.

Today, the pill is like a lifestyle supplement, which is often more about smooth skin than contraception. The newer preparations also have a slightly dehydrating effect, so that women lose some weight. The price for it: more thromboses. "Every day I have young women with the most severe pulmonary embolisms in my life, those are 17, 18, 25 and have taken the pill, usually the new third or fourth generation, if the history had been more conscientiously asked and the family asked you can partially avoid the diseases. "

For women who know of their increased risk, there are alternatives. Doctors advise against changing the pill, as side effects occur especially in the first year."Do not let yourself be confused," says Kiesel, "but take warning signs such as aching legs, unexplained back pain, or shortness of breath seriously." Then it says: off to the doctor and necessarily point to the pill. Karolin himself has a spiral now. The support stockings, which she had to wear for two years, she has recently been released. But blood thinners still take them, probably for life.

Contraception without risk:

Non-dangerous in terms of thrombosis are procedures without hormones: Copper spiral and chain, diaphragm and natural methods (eg cycle computer), Also IUS and Mini-Pill do not increase the risk according to studies.

Always important: the individual consultation by doctor.

Here you will learn everything that is important if you want to sell the pill.

Preventing Venous Thromboembolism (March 2024).



Contraception, thrombosis, birth control pills