Thrombosis while taking the pill

introduction

The birth control pill increases the risk of thrombosis (see: Thrombosis Risk Factors). Some women have had this experience and developed a thrombosis while taking the pill. This leads to the formation of a blood clot in one or more blood vessels, which, in the worst case, closes this vessel. The clot can also be carried into other important blood vessels and in this way lead to a pulmonary embolism, for example. This is potentially life-threatening, so taking the pill should always be critically questioned with regard to the risk of thrombosis.

There are also other side effects of the pill.

With regard to the individual preparations, there are differences in the risk of developing a thrombosis during therapy. The gynecologist should therefore preferentially prescribe preparations with a low risk of thrombosis for his patients.

Further on this topic: Desogestrel

root cause

Thrombosis occurs when taking the pill due to various processes. The pill contains female sex hormones, the so-called Estrogens and Progestins. These hormones lead to one in the blood Increase in coagulation factorswho are responsible for the blood to clot and, for example, to close an injury. At the same time, there are fewer substances in the blood that counteract coagulation (e.g. antithrombin-III). Women who are already under one anyway Coagulation disorder suffer, have to be particularly careful when taking pills for the reasons mentioned. By a lower flow rate of the blood, the risk of thrombosis increases, as the blood can then clot more easily.

Hence, for example Smokers particularly at riskdeveloping thrombosis when taking pills. nicotine causes blood vessel constriction. In addition, the contents of the cigarettes damage the vessel walls and thrombosis can develop even more easily. Clear overweight Women also have a higher risk of thrombosis when taking the pill, as adipose tissue also produces female hormones and thus causes an increase in clotting factors and platelets (thrombocytes) in the blood.

Not all birth control pills increase the risk of thrombosis in the same way. Especially those newer third and fourth generation pills are suspected that Increase risk the most. Especially pills with the progestin Drospirenone are considered the most critical preparations in terms of the risk of thrombosis. These preparations should not be prescribed to patients who already have an increased risk of thrombosis. In addition, the risk of thrombosis under the pill is special in the first few months after taking a new dose the pill increased. This means that the chance of developing a thrombosis is relatively low in a woman who has been taking the pill for a long time without any problems.

Symptoms

The most common thrombosis occurs in the Leg veins (please refer: Thrombosis in the leg).

The typical signs of a thrombosis are a reddened, overheated, swollen lower leg or feet with tight, shiny skin. The calf is often very tender on pressure. Pain is also common when running. These can resemble sore muscles.
Another typical is a Heaviness in the affected leg. Depending on where the thrombosis is located, the whole leg can also be affected.
If the tip of the foot is pulled up, i.e. towards the nose, pulling usually occurs Calf pain (please refer: Thrombosis pain) on. The symptoms usually get worse when the patient is standing and improve when lying down or when the leg is raised.

However, thrombosis can also cause very few to no symptoms. It mainly depends on the degree of expression.

Diagnosis

Various diagnostic methods can be used to rule out pill-related thrombosis. First of all, the doctor will do this Describe the patient's symptoms let and one physical examination carry out.

Various Testing indicate a possible thrombosis. For example one Difference in circumference between the two lower legs. To do this, the doctor measures the circumference of the lower leg with a tape measure just below the kneecap. In a healthy person, the circumference of both lower legs should be do not differ by more than 3cm.
The doctor will then compress the leg with your hands and open it Tenderness to verify. He will also press the sole of the foot and ask the patient to do the Tiptoe towards your nose. Solve these tests (Meyer, Payr and Homans sign) Pain, it could be a thrombosis.

Further diagnostics if a thrombosis is suspected by the pill is finally one Ultrasound of the veins. The doctor can see directly whether blood vessels are blocked. If this examination method is not sufficient to make the diagnosis, other imaging methods can be used, for example one Computed Tomography to the Rule out pulmonary embolism. The so-called D dimers can be determined, which are usually increased in a thrombosis. These are breakdown products from the coagulation system that indicate that blood clotting has been activated.

therapy

The Basic therapy A thrombosis involves wearing suitable Compression stockings as well as taking anticoagulant drugs. The compression stockings prevent the swelling of the leg from increasing and increase the return flow of blood to the heart. This prevents further development of the thrombosis and alleviates the symptoms. The patient also receives Heparin, an anticoagulant drug that prevents the patient from developing further thrombosis. The existing thrombosis is usually not resolved.

In the case of very pronounced thromboses or a pulmonary embolism, a so-called Fibrinolytic be prescribed, which breaks down the thrombus. Alternatively, the blood clot can be surgically removed from the vessel (see: Therapy for thrombosis). It is important that, after a few days, the patient is on an anticoagulant drug, for example Marcumar, is set. This must be taken for a few months.

If the thrombosis is actually due to taking the pill, it should be discussed Stop taking the pill. Otherwise it is not unlikely that thrombosis will occur again in the future. The woman should either stop taking the pill altogether or at least on one Product with low risk of thrombosis changed become.

Prophylaxis / prevention

In order to avoid thromboses caused by the pill, it is advisable to do it extensively advised by the gynecologist to let which preparation is suitable. Not all pills carry the same risk of thrombosis. Preparations with a low risk of thrombosis are preferred. Women who smoke or overweight are, in this regard, should take the pill if possible do not takeso as not to further increase your risk of thrombosis.

Otherwise, general measures should be taken that are suitable for avoiding thrombosis. This particularly includes sufficient physical movement. This means that even on long journeys by plane, bus, train or car you should always get up and walk a bit so that the blood in your legs does not build up too much. Women who are at risk for thrombosis can do long trips Thrombosis injections can be prescribed and administered prophylactically.

forecast

The prognosis of venous thrombosis from the pill is good overall if the thrombosis is detected in good time. As long as it doesn't become one Pulmonary embolism has come, i.e. the blood clot has not been flushed into the lungs, the thrombosis can usually be treated well. If a pulmonary embolism has occurred, this also counts timely therapyin order to be able to help the woman adequately. In women with risk factors for thrombosis, follow-up care and adjustment are on anticoagulant drugs especially important to avoid further blood clots.

Also read: Pulmonary Embolism Symptoms.

Stop taking the pill?

If a thrombosis developed while taking the pill that cannot be explained by factors other than the pill itself, for example a long flight with little movement, then that is the case Stopping the pill advisable. Otherwise, it is not unlikely that such a thrombosis occur again becomes.

There are other ways of prevention, which have a significantly lower risk of thrombosis, for example the spiral. This releases hormones locally on the uterus, only small amounts of which reach the bloodstream and therefore cause only a very low or no increased risk of thrombosis. You can also switch to a preparation with a lower risk of thrombosis under the pills themselves if the thrombosis is caused by a preparation with a high risk of thrombosis.

• Mechanical contraceptives
• Hormonal contraceptives

Morning-after pill

The risk of thrombosis with the morning-after pill is rather low. It is true that these are also female sex hormones that are administered in high doses, but because of the single dose, the administration period is too short for relevant effects on blood clotting to be expected.
In principle, however, it is possible that the morning-after pill could lead to a thrombosis. The probability is currently given as 1: 5,000,000. Women with an already increased risk of thrombosis are particularly at risk, which is why the morning-after pill is not recommended for these women.

Read more on the subject at: Side effects of the morning-after pill and Effect of the morning-after pill.

flight

The pill influences blood clotting and can promote the development of thrombosis. By long air travel, in which the woman sits a lot and cannot move her legs sufficiently, the risk of thrombosis also increases as the blood sinks in the legs and the flow rate decreases. This can make the blood clump more easily and create clots in the leg veins (Leg vein thrombosis) form. Through the Combination of pill and air travel can accordingly also more easily develop a thrombosis.

Women who have a increased risk of thrombosis to have and take the pill, should consider before a long trip Thrombosis injections and get this set before departure. This significantly reduces the risk of developing a thrombosis.

Women who no increased risk of thrombosis have, need no thrombosis injections before starting a trip. It is enough to pay attention to regular movement of the legs during the trip. Standing up in between or moving your feet vigorously up and down while sitting is usually sufficient.

Smoke

Smokerswho take the pill have a significantly higher riskto suffer a thrombosis than non-smokers who take the pill. This is because both the pill and smoking each lead to an increased risk of thrombosis. If both risk factors come together, the overall risk increases accordingly. By the Smoking constricts the blood vessels and it comes to Vascular wall damageto which Blood clots accumulate faster can. This mechanism is favored by the lower blood flow velocity.

Especially female smokers who are older than 35 years, should the Avoid taking the pill if possible, or that Refrain from smoking. From this age onwards, studies with this constellation of risk factors showed a particular risk for thrombosis. Smokers should therefore generally use a different one Contraceptive method recommended. For example, are suitable Condoms, Diaphragm or the spiral. The latter contains significantly fewer hormones than the pill.