Health & Fit Experts warn birth-control pills could increase the risk of 'deadly blood clots' in coronavirus patients
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- A new report warns that certain types of birth control pills, pregnancy, and hormone therapies may increase the risk of "deadly blood clots" in coronavirus patients.
- Both estrogen and COVID-19 are linked to an increase risk in the clots.
- More research is needed before making any one-size-fits all recommendations, and patients should talk to their providers to weight their risks.
Coronavirus, on certain birth control pills, or taking estrogen-based hormone replacement therapy may be especially vulnerable to potentially deadly blood clots, doctors warn in a (not-yet-peer-reviewed) manuscript out today in Endocrinology.
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That's because estrogen — which goes up during pregnancy and is a key ingredient in many types of birth control and HRT — is known to increase the risk of blood clots..
The two together, then, may amplify the risk, the doctors hypothesize.
But more research is needed to learn more about how the two factors interplay, and how patients respond to the potentially increased risk needs to be balanced with the downsides of stopping medication or receiving an anti-clotting medication while pregnant.
"This definitely needs to be [decided through] individualized counseling where patients are really presented with all of their options,", an OB-GYN at the University of South Florida, told Insider.
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The Affordable Care Act made birth control more accessible than ever. Then came Trump.Some want to prevent pregnancy. Others need a way to regulate painful or irregular periods. One patient has premenstrual dysphoric disorder, a very severe form of PMS.
Blood clot risk is still pretty low among women on birth control pills
Combined oral contraceptives, or those with both estrogen and progestin, increase the risk of blood clots (technically called venous thromboembolism or VTE) two to six times.
They also increase the risk of clots when compared to progestin-only birth control pills, though the risk is still "very low," according to theat only a .
, also may raise your risk of clots because they have estrogen while IUDs do not.
The risk of clotting is much higher during pregnancy and right after childbirth than on estrogen-based birth control.
In terms of the risks COVID-19 poses for blood-clot development, onefound 31% of ICU patients had "thrombotic complications," which the researchers called "remarkably high."
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have shown the clots appear in "almost every organ," a result study author Dr. Amy Rapkiewicz, NYU Langone Medical Center's chair of the department of pathology, told was "dramatic."
Even people with mild cases of COVID-19 who don't wind up in the hospital may experience blood clots, but.
, heart attacks, kidney problems, , and more.
How to respond to the potential increased clot risk varies by patient
The paper's corresponding author, Dr. Daniel I. Spratt of Tufts University School of Medicine, said in a press release that more research is needed to know whether, on the whole, women on estrogen-based birth control pills or HRT should stop if they get COVID-19.
It's also unclear whether pregnant women with COVID-19 should receive a type of anti-clotting therapy, he said.
"Research that helps us understand how the coronavirus causes blood clots may also provide us with new knowledge regarding how blood clots form in other settings and how to prevent them," Spratt added.
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Meantime, Rapkin said it's important for women and their doctors to make a decision that's right for them while considering the trade-offs.
"If women stop their birth control but keep having sex," she said, "they're then at risk for unplanned pregnancies, and we know the risk of clot is higher with pregnancy than with estrogen-containing contraceptives."
The same goes for people on estrogen-containing HRT, with age and comorbidities like heart disease, obesity, and a family history of blood clots being important considerations, ACOG says.
Doctors should continue to make recommendations, the organization says, "based on the individual patient's desires, risks factors, and needs."
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