BEFORE YOU READ THIS STORY: Blood clotting associated with some contraceptive pills is rare and distinct from blood clotting with the Astra Zeneca vaccine. Please consult your local GP for individual medical advice.
GPs have known about the rare occurrence of blood clots associated with some contraceptive pills for decades.
But despite the urging of doctors that Australian , a small number of cases of blood clotting linked to the AstraZeneca vaccine have renewed discussion about their risks.
In the course of researching this story, The Feed received a flood of emails from women.
Many claimed they were given insufficient information about the contraceptive pill and its potential side effects, including the rare risk of blood clotting, before being prescribed it.
Ella* told The Feed she was 14 years old when she was prescribed a contraceptive pill to clear up her acne, despite a family history of severe blood clots.
“The only discussion was about the other creams I had tried to clear up my acne. It was just posed as a potential treatment to help clear it up,” she told The Feed.
Years later, when she was 23 years old, Ella woke up with a pain in her leg and thought she had simply slept funny or pulled a muscle.
Source: Getty
But when the pain moved from her upper thigh to her lower back and into her lungs, Ella consulted her doctor.
“They sent me to get a scan on my lungs and it came back that I had pulmonary embolisms,” Ella said.
is a blockage in one of the pulmonary arteries in your lung, which is most often caused by blood clots that travel to the lungs from deep veins in the legs.
Since her first blood clotting case, Ella developed two blood clots in the brain - one in 2012 and one in 2019.
“The contraceptive pill is amazing and such a life-changing medication for women, however, there needs to be more education and conversation around the risks associated with taking any new medication,” she said.
Gina* claims she had a similar experience. She told The Feed, a couple of years ago she was diagnosed with pulmonary embolism and had three clots on her lungs.
“By the time it was found the clots had already started to kill off part of my lungs,” Gina said.
“The clots were found to have been caused by the pill. After the clots were found I was told that I never should’ve been on the pill I was on,” she added.
Source: Getty
“I am now unable to be on anything with hormones, such as the pill or IUDs [[small contraceptive devices that are inserted into the uterus] and have to take blood thinners when I fly and a daily injection when pregnant until 6 weeks after the birth.”
How common are blood clots on the pill?
The rate of blood clots in the AstraZeneca vaccine is roughly one in every 250,000, according to Vice-president of the Australian Medical Association Dr Chris Moy.
By comparison, the risk of getting a blood clot per year from being on the pill is one in 2,500, Dr Moy said.
However, the risk of getting a blood clot increases during pregnancy. This means women on the pill are at a smaller risk of developing blood clots than pregnant women.
Blood clotting associated with the vaccine is like an “allergic reaction”, causing platelets - which make clots - to clump, according to Dr Moy.
Dr Moy said the government has advised those under 50 to take the Pfizer vaccine rather than the AstraZeneca jab, as blood clotting appears to be occurring mainly in young people.
He emphasised there is no additional risk for women on the contraceptive pill of getting blood clots on the AstraZennaca vaccine.
“People are getting clots but low platelets, which doesn’t really make sense. It has nothing to do with any previous clotting history at all, including other medications like taking the pill.”
The GP and the patient: Shared decision making
Jane* had been taking the pill for 10 years when a non-regular GP alerted her that due to her history of recurring migraines, she was at high risk of developing a stroke and blood clots.
“He was so worried about my being on the pill for so long with the risk that he contacted me multiple times to try and get me onto a different contraception,” she told The Feed.
“I took his advice and changed contraception, but every time I've been to another doctor to discuss contraception, I am the one who brings up the risks of the pill to me (even though my migraines are on file).”
Jane claims none of her friends who have migraines were aware of potential risks associated with the pill until their mid-30s -- years after being on the pill.
The rate of blood clots caused by the AstraZeneca vaccine sits at roughly one in every 250,000. Source: AAP
She told The Feed she feels like the risks associated with the pill are “barely talked about”.
Dr Moy said the unusual blood clotting reaction with the vaccine, while distinct from the pill, has highlighted the importance of the doctor-patient relationship.
“I think a long time ago, there was this perception of doctors as gods basically. The old-style relationship was that a doctor would tell you what to have,” Dr Moy said.
“We live in a different world [now] and there’s a much more mature relationship between the doctor and patient.”
Women should be empowered with information about their healthcare, said Dr Deborah Bateson, a Clinical Associate Professor of Gynaecology and Neonatology at the University of Sydney and Medical Director at Family Planning NSW.
“There’s a lot of information to cover about how it works, what to do if you miss a pill, what the side effects are,” Dr Bateson said.
Dr Bateson believes the initial consultation for prescribing the pill can be lengthy but doctors should not “underestimate” women and instead, provide them with as much information as possible.
“My job as a doctor is to ensure I’m absolutely providing a pill safely to someone but also giving them all the information as well.”
Patient Ella* said more must be done to make GP offices a “safe space” for young women, where they are encouraged to ask questions.
“It’s pretty difficult for a female in their late teens or early 20s,” she told The Feed.
Ella believes a small number of GPs can be dismissive of women’s health issues, making conversations around healthcare “intimidating” for young women.
Female doctor waving to telehealth patient Source: Getty Images/FatCamera
Dr Bateson said research has shown young women often feel uncomfortable when discussing contraception options with their GP.
“It’s really important that we’ve got consumer-friendly information for women and that we’re able to support women in feeling empowered to ask questions of their doctor.”
Dr Moy said people should talk to their doctor about the benefits and risks of taking the pill, including “blood clotting, breast cancer, cervical cancer and heart attack risk.”
But he said people should also talk to their doctor about the risks of not taking the medication.
“What a doctor should do is be offering treatments they believe to be of medical benefit,” Dr Moy said.
“When you talk about contraception, you need to talk about all of the options; condoms, diaphragms. That’s why a discussion about contraception at the start is not going to be short.”
“Whatever you do in life has a risk or benefit. Getting out of bed is a risk, walking across the road has a risk. There’s also risks with taking medications and vaccinations.”
*Names have been changed to protect privacy
