Birth Control After a Pulmonary Embolism, DVT, Blood Clot, Factor V Leiden, Thrombophilia, or Other Clotting Condition

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Problems With Oral Contraception

Oral contraception is commonly used by many women. It is also the cause of many blood clots. Combined oral contraception can increase the chance of blood clots such as pulmonary embolism or deep vein thrombosis (DVT). While the risk is only raised between 4-8%, the risk is much higher for women who have had a previous pulmonary embolism or DVT, especially if the blood clot occurred while the woman was on hormone therapy or oral contraception. For women who have had a pulmonary embolisn, DVT, or have thrombophilia this is a huge problem. Once a woman has had a clot or has been diagnosed with thrombophilia (the most common being Factor V Leiden), doctors will typically recommend that hormone based contraception be avoided.

Involving Your Doctor

Birth control is a very important topic to go over with a doctor. Speaking to more than one of the doctors that is working with a patient is often the best way to get an answer that the patient can be confident about. Some of the best choices of doctors to speak with are the patient's primary care physician, hematologist, and OBGYN. The various doctors can answer questions about the risks of pregnancy, interactions with anticoagulation, and risks and benefits of the different forms of contraception.

Please discuss everything in this Hub with your doctor. I am not a medical professional, just a patient and patient advocate.

Did you have a blood clot while using hormone based birth control?

  • Yes, while using a product with estrogen and progesterone (combined oral contraceptives, COCs)
  • Yes, while using a product that ONLY contained progesterone
  • No
See results without voting

An Introduction to Hormone Based Contraception

Understanding the risk of blood clots, pulmonary embolism, or DVT with hormone based contraception requires a basic understanding of the general classes that these medications fall into.

There are primarily two types are hormones that can affect fertility: estrogen and progesterone. Contraception will never list estrogen or progesterone, rather it will list the name of the synthetic variation of the hormone or hormones that are used. Progesterone that is used in smaller doses without estrogen has little impact on the clotting system. When estrogen and progesterone are used together, the risk of a clot increases. patients with a clotting condition such as Factor V Leiden who were using birth control pills that contained estrogen and progesterone can have up to a 35 fold higher risk of a clot.

Some contraception only uses progesterone while other forms combine estrogen and progesterone. This will be a very important distinction in the discussion of birth control and clots. Other factors that can influence clotting include the dose strength of the hormones, the type of synthetic progesterone used, and the delivery method that is used.

Dangerous Birth Control - High Clotting Risk

There are a few forms of birth control that come with a very high risk for clots. These forms of birth control should not be used by anyone with a history of pulmonary embolism, DVT, blood clot, or stroke. Additionally, patients with a blood clotting condition (thrombophilia) such as Factor V Leiden should not use these forms of birth control.

According to the National Alliance for Thrombosis and Thrombophilia, you may be able to use some of the below methods if you are on anticoagulation therapy. Coumadin (warfarin) can cause increased menstrual bleeding that may be eased by some forms of hormonal contraception. This can be discussed with doctors to determine if this is the right decision for a patient.

Combined Oral Contraceptives

Most oral contraceptives fall into this category. This type of pill is any pill that contains both estrogen and progesterone. These pills raise the clotting risk because they contain both of these hormones. There is some concern that the newer brands of COCs put women at an even higher risk of blood clots than the older, second generation pills. Many women have their first clots while on a COC.

Anti-Androgen Oral Contraceptives

A less common form of the pill contains estrogen and an anti-androgen known as cyproterone. Pills with cyproterone put users with no history of clotting conditions at an 8% higher risk of having a clot. If it increases the risk this much in the typical population, it will be an even larger risk for people already at a higher risk of clots.

The Patch

The birth control patch (Ortho Evra) seems to put patients at a higher clotting risk than combined oral contraceptives. It also contains both estrogen and progesterone. It seems that women that are using the patch absorb approximately 60% more estrogen into their bodies than women who are using COCs. In 2006 the FDA required the name brand patch Ortho Evra to update their labeling to note the increased risk of venous thromboembolism, the type of clots that cause DVT and pulmonary embolism.

The Ring / Hormonal Vaginal Insert

The birth control ring (NuvaRing) also contains estrogen and progesterone. It seems to carry the same risks as combined oral contraceptives and should also be avoided.

An Implannon Progesterone Implant
An Implannon Progesterone Implant | Source

Lower Risk Birth Control

As mentioned above, progesterone by itself does not seem to cause clotting problems in the dosages that are given in hormonal contraception. While progesterone given in large doses to treat things like vaginal bleeding does cause clots, progesterone in the smaller doses used for contraception does not appear increase the risk of pulmonary embolism or DVT.

All of this being said, many doctors and patients still have some concern about hormone use after a pulmonary embolism or DVT. On pulmonary embolism recovery support group boards I have seen a number of people who feel that progesterone only contraception contributed to their pulmonary embolisms. WHO rates progesterone only contraception as a "2". A 2 means that progesterone only contraception can general be used but should be monitored and followed up with caution. In fact, many of the brands of progesterone only contraception will note that patients with a history of venous thromboembolism (blood clots like a pulmonary embolism or DVT) will need to speak with a doctor about clots before using the product. If you are interested in any progesterone based contraception the best bet is to talk it over with your pulmonary embolism recovery team. Your OBGYN, general practitioner, and hematologist can give you their feelings about this type of contraception. Based on what they tell you, you can make an informed decision about what is right for your body.

Skyla (NEW!!!)

Skyla is the newest IUD available in the United States. Skyla is exciting because it is a very small IUD and may be more comfortable for women who have never been pregnant. Skyla is also exciting because it has no prescribing warnings for blood clot survivors or individuals with thrombophilia. For more information about Skyla and blood clots see Clot Connect. Skyla has very low levels of progesterone. These levels are lower than Mirena. Due to the low progesterone levels, Skyla must be replaced every 3 years. Skyla is over 99% effective at preventing pregnancy.

Progesterone Only Pills (POPs, Minipill)

Progesterone only oral contraceptives (also known as POPs or the minipill) are nowhere near as common as combined oral contraceptives. If taken exactly as prescribed, the minipill offers 92% effectiveness at preventing pregnancy. Due to the lower amount of hormones in the minipill the patient must take it at exactly the same time everyday. If the minipill is taken even an hour late the risk of pregnancy goes up! This contraceptive also changes the menstrual cycle quite a bit and often causes spotting.

Depo Provera (Progesterone injections)

Depo Provera is a progesterone injection that is given every three months. It has a 97% effectiveness rating. It changes the menstrual cycle substantially when used. Many women will stop having a period while on these injections. Like other progesterone only methods, there is no research indicating that it will increased blood clots, but a doctor should be involved when there is a prior history of pulmonary embolism, DVT, or other clots.

Mirena (IUD with progesterone instead of copper)

Mirena is an intrauterine device (IUD) that is coated with progesterone. It is placed in the uterus by an OBGYN and then will remain in place for p to five years. While the progesterone in this method does enter the body, some feel that it is more localized to the uterus and may be less of a risk for progesterone based side effects. It changes the period dramatically and many women stop menstruating after some time. For these reasons, it reduces the effects of PMS and menstruation. It is 99% effective at preventing pregnancy. Doctors used to feel that IUDs were only useful for women who had been pregnant in the past. It is now known that women who have never carried a child MAY use an IUD. One of the downsides to this method is that it puts women at a slightly higher risk for infection and pelvic inflammatory disease. For this reason, IUDs are not a good choice for women who have multiple sex partners.

Implannon (Progesterone Implants)

Implannon is a progesterone implant that is implanted in the upper arm. It releases progesterone into the body. It is 99% effective and carries the same risk of blood clots as other progesterone only methods. It will work for three years at the end which it can be removed or replaced. Like Mirena and Depo Provera, Implannon disrupts the menstrual cycle.

Copper IUD
Copper IUD | Source

Hormone Free, No Clotting Risk Birth Control

Birth control without any hormones is the safest method of birth control for anyone who has a history of blood clot, DVT, pulmonary embolism, Factor V Leiden, or any clotting conditions or thrombophilias. All hormones increase the clotting risk. Some increase it by a small amount while others are a huge risk.

Hormone free birth control largely consists are various barrier methods although IUDs, natural family planning, and withdrawal also fall into this category.

Copper IUD

Throughout the world there are many types and brands of copper IUDs. In the United States there is only one brand, Paraguard. The copper IUD is typically a small plastic, t-shaped piece of plastic wrapped in copper wire. Most forms of the copper IUD are 98% effective at preventing pregnancy, although this does vary by brand. In some countries there is a smaller version of the copper IUD that is available for women who have never been pregnant. This version is not available in the United States. Some women will find this to be a challenge as there is a higher rate of expulsion (the body kicking out the IUD) for women who have never been pregnant who use the standard size copper T. Like other IUDs, the copper IUD puts a woman at a higher risk for PID. This means that it is only a good choice for monogamous couples. It also may not be a good choice for women who have problems with menstrual cramps or excessive bleeding.

Note: Some women will have excessive bleeding during menstruation while on Coumadin/warfarin. Talk to you doctors about this possibility.

Condom (male and female)

The condom may be the most famous birth control out there. It is convenient as it takes no prescription. They can be obtained at numerous stores in person or through the Internet. Standard, male condoms are 98% percent effective when used every time and used correctly. There is also a female condom available. It is slightly less effective (between 80%-95%), more expensive, and can be more difficult to find in stores.

Cervical Cap

A cervical cap is a small, cuplike device that is worn inside up against a woman's cervix. Different brands have different effectiveness ratings but all of them are over 90%. In the United States, a cervical cap requires a prescription. The brand that is currently available is called FemCap. This particular brand is 92% effective when used with spermicide. Many people like that it can be placed before intercourse and that it can be used for multiple intercourse sessions. A downside of this method is that some people cannot tolerate nonoxynol-9, the primary ingredient in spermacide. FemCap's makers note that this cervical cap has a special ridge to hold the spermacide and reduce irritation. To get a FemCap, visit the company website or order one online at Lady to Baby.

Diaphram

The diaphragm is another well known birth control method. It is another internal device that is worn by the female to cover and block the cervix. It also is used with spermacide so users who are irritated by nonoxynol-9 may have problems with this device. It is only85% effective at preventing pregnancy. It must be fitted by a trained OBGYN. It must be re-fitted after weight changes, pregnancy, or abortion. Some couples like that it can be placed before intercourse and can be left in for multiple intercourse sessions.

Spermacide

Spermacide can be used on its own as a contraceptive. There are a number of types of spermacide available for this purpose. At this time, they all contain nonoxynol-9, a known irritant. By itself spermacide is only 78% effective. The tissue irritation that nonoxynol-9 causes, can be very painful for some people. Also, research is showing that the irritation increases the risk of contracting a sexually transmitted disease such as HIV.

Contaceptive Sponge

The contraceptive sponge is another option that uses nonoxynol-9. It is 89% effective. It is placed internally to prevent sperm from entering the cervix. It is available over the counter and can be purchased at most drug stores. It cannot be used while a woman is menstruating. In the United States it goes by the brand name Today's Sponge.

Natural Family Planning

Natural family planning is a method that uses the woman's body signals and schedule to determine when she is least likely to become pregnant during sex. It is accepted by some churches as a way to prevent pregnancy when it is an unsafe time for a woman to conceive. There are many versions of this method. Some now include the use of electronic fertility monitors. These can be found at Lady to Baby. The site is above in the recommended links. The methods vary greatly on reliability. Research the different methods if you are interested to learn which one is best for you.


Summary

There are a number of contraceptive choices available for women who are at an increased risk for clotting. This is important as pulmonary embolisms can be fatal. It is also important for women who are recovering from pulmonary embolisms as their bodies often need time to heal before becoming pregnant. Hormone methods that include estrogen should be avoided unless recommended by a doctor while a woman is on anticoagulation. Other options that are not mentioned here include sterilization and withdrawal. Also, if absolutely necessary, Plan B can be discussed as it is a progesterone based emergency contraception.

It is very important to consider health conditions, medical treatments, and personal lifestyle when making this decision. Read over everything and discuss it with your doctor.

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Comments 30 comments

Bea Wiser profile image

Bea Wiser 4 years ago from Midwest, USA

Very important subject. Just to clarify absolute risk : healthy women not on the pill will have a 4 per 10000 chance of getting a blood clot, on one of the older pills a 6 per 10000 chance, on the patch, yaz or the ring 8-10 per 10000 chance. If you get pregnant your chance of blood clot is 20 per 10000 These numbers are from FDA reports from 12/11. So even if you say your chance is doubled it is still a pretty rare occurrence. Not sure what risk is with clotting disorder or history of clots but no one would argue that these are absolute contraindications to combined hormonal contraception.


Lwelch profile image

Lwelch 4 years ago from USA Author

Thanks for the numbers. You are right, it is very low. I hadn't pulled up the stats myself. Do you have a link for those numbers? It would be helpful for me to have that document in my "link library".

The raised risk with clotting conditions varies with the condition. I believe that heterozygous factor V leiden + COC = 30% increase in risk. The NATT newsletter that covers that doesn't have any exact stats in it. (http://www.stoptheclot.org/Newsletters/FINAL_Sprin...

If you have any good info send it my way!


shesacraftymom profile image

shesacraftymom 4 years ago

I wonder what the stats are for women over 35 who smoke. I know a few like that. I assume the risk is higher at that point.


Bea Wiser profile image

Bea Wiser 4 years ago from Midwest, USA

I have had these numbers tweaked out from conferences I have gone to but could not find direct source yet. I will keep looking. Meanwhile, Here is a very entertaining and informative blog (not mine) by a OB/GYN on the subject:

http://www.tbtam.com/2011/12/patch-pill-visualizin...


Lwelch profile image

Lwelch 4 years ago from USA Author

I would agree that the risks are higher for over 35 that smoke. Every pack of oral contraceptives notes that the clotting risk is higher for those groups. I think I will go pose that question at www.managingcontraception.com.

Bea, thanks for looking it up :)


Lwelch profile image

Lwelch 4 years ago from USA Author

For those wondering about the risk of clots and testing for Factor V Leiden check this out:

http://www.bmj.com/content/313/7065/1127.full


Lwelch profile image

Lwelch 4 years ago from USA Author

Just found it... 4/1,000 women with FVL who are on a COC will have a VTE of some sort.


Rachel 4 years ago

I want to thank you for this information - I did a huge amount of research on birth control options after my DVT and subsequent discovery that I am homozygous for the Factor V Leiden mutation. This is the best and most comprehensive collection of information on the subject that I've seen.


Lwelch profile image

Lwelch 4 years ago from USA Author

Thank you! If you have any questions, please let me know. You can reach me through a hub pages link to me in the upper right.

Did you choose to stay on anticoagulation as you are homozygous?

If you have any tips about birth control from your experiences share in comments as I would love to hear them!


Beth 4 years ago

I also have factor V and am now taking a progestrone based controception... Ive found the information on this site to be very helpful.. my primary doctor disagrees with my gynecologist as to wether i should be allowed to be on this medication... it was really good to see things in black and white and read for myself percentages and odds.. I do plan on continuing my anticoagulations while taking the hormone


Lwelch profile image

Lwelch 4 years ago from USA Author

I have seen a lot of debate in this area on many support groups. My doctors were fine with my choice. I also went to managing contraception and asked the question to the doctors who watch a Q&A area and got the okay. I would print out some information and share with your doctor. Make sure it is the stuff from some of the referenced sites and not me as I am a patient and I doubt that would help you out.

Stop The Clot sees reasons to use hormonal contraception while on anticoagulation. Warfarin can cause excessive menstruation in some women and hormones alleviate that.

Make sure you know you clotting symptoms. Read the sites that I referenced. Ask doctors. That is the best thing that you can do. You are on the ball involving your team of doctors.

You will see a lot of controversy on this issue. As I mentioned, in high doses, progesterone does cause clots. I am glad that you have had a chance to hear both sides, talk to multiple doctors, read the numbers, and decide.

Thanks for stopping by! Best wishes with anticoagulation!


Jean Bakula profile image

Jean Bakula 4 years ago from New Jersey

Thanks for a very informative article, which outlines alternate and safer means of birth control. I am past the age of needing it now, but stopped getting periods in my late 30's, and saw two gynecologists who insisted I needed to be on hormone therapy so my body would keep having periods. I gained 25 lbs. in 6 months, and began having high blood pressure. No doctors would listen to me when I told them the pills were not agreeing with me. I finally had to lose the weight after I got my BP under control, and found a new OBGYN, a woman, who gradually got me off the hormone therapy. We did it little by little, and even she didn't know how it would affect me! I lost 60 lbs (but was dieting anyway), and stopped having the very light periods that the pills produced.. But now when I look at pics, I can see how bloated they were making me, so I think HRT is very dangerous, and advise people against it. I know younger women go on drugs to have less periods, but I think nature and your body know best. Great job.


Bobski606 profile image

Bobski606 4 years ago from U.K

A very interesting article. I recently found out that I have factor v leiden after being rushed into hospital with a 3ft blood clot that had been growing for the last 3-4 years (how they missed it I have no idea) but I had been on the combined pill for 9 years. I'm now off of hormonal contraceptives and I'm unable to use them in the future. Depending on how my condition improves I might be able to have the copper coil to control my menstruation as I'm on anticoagulants and it gets pretty bad. Do you know of any one in a similar situation to me who has had success with the copper coil? Thanks again for the brilliant article.


Lwelch profile image

Lwelch 4 years ago from USA Author

Copper IUDs tend to increase menstruation. I know - not good news.

I recommend trying your question at http://www.managingcontraception.com/qa/index.php?...

The doctors that are behind that site are good about getting back to you.

I know when I wrote them I was advised that I should be fine with the Mirena - a progestin coated IUD. It has the nice effect of lessening menstruation for most women. It stops menstruation for some.

Heavy bleeding is a problem while on warfarin. A stop the clot newsletter on women's health goes over that very problem: http://www.stoptheclot.org/Newsletters/FINAL_Sprin...

I can definitely see why you are avoiding hormones! I am amazed, as you are, that that clot was able to go unnoticed and relatively problem free for as long as it did! I am glad that it was found before anything worse happened.

I am glad the article helped - if you have any personal questions about birth control feel free to message me through hubpages.


Rose 4 years ago

None of these statistics posted here are accurate!Blood clits and pulmonary embolis are on the rise in high numbers, somewhere now up to 1 in every 1000 women are developing blood clots, even resulting in death!!Please beware when taking any oral contraceptives, read the warnings and do not be a statistic!! Pharmaceutical companies are trying to cover up these dangers, and it is not rocket science if you are wondering why? Birth control pills/oral contraceptive sales are one of the largest money makers in the United States. I speak from experience here first hand , please beware, from one woman to another!!!!! Seriously grieved!!


Lwelch profile image

Lwelch 4 years ago from USA Author

Hi Rose,

Thanks for reading. The numbers presented come from a number of sources, primarily support groups and research groups for venous thromboembolism (blood clots). I had multiple, bilateral, large sized pulmonary embolisms diagnosed in 2008. I understand your fear. I shouldn't be alive. My largest risk factor was combined oral contraceptives. I also had risks from extended air travel and Factor V Leiden.

Yes, there are going to be some companies trying to cover up information. This is why I prefer to look at US death and mortality statistics, health insurance analysis of ICD-9 codes, and research done for the blood clot support groups, a number of which are investigating the links of birth control to venous clots. Their research is what put huge black box warnings on the birth control patch after the US adverse events reporting found that the pulmonary embolism and DVT risks were greatly increased with the use of this product. A great deal of research is now going on with the 3rd generation progestins and combined oral contraceptives. Some studies have shown a huge risk while others have shown none. We will have to wait and see on that one. Mortality numbers, insurance claims, and adverse reports will come in and eventually there will be a clear picture.

Hormones are a huge factor in clots. Pregnant women and women who were pregnant in the last 6 months are at a very high risk for clots. Clotting factors likely go up with hormones to keep us from bleeding to death when giving birth.

Don't take any of this to mean that I feel that hormonal contraception is not a problem. The point of this hub is that it IS a problem. If you have clotted before you must seriously consider the risks. Pharmaceutical companies will want to find a better solution as they will make more money if they can someday write on their boxes that there is no risk. This is why we don't see them trying to see first generation oral contraceptives anymore - their side effect profiles were atrocious due to the large amounts of estrogen.

There are many alternative birth control methods that are explained in this hub. I encourage you to consider one of them and talk it over with your doctor. Rose (and all the other ladies) please, please, please protect yourself from clots and look at the alternatives and then discuss them with your hematologist and OBGYN.

So, now for some numbers from emergency room reports of ICD-9 codes:

DVT - average age of DVT in females is 65, in males it is age 60. Interestingly the risk for males of all ages is 1 in 2,190. Women have a risk of 1 in 2,540. Not what I expected. Men are at a higher risk for a DVT type clot, they never take birth control or get pregnant so I am surprised.

Pulmonary embolism. Men get them at an average age of 55 and women at age 57. 1 in 8,800 men will have a pulmonary embolism while the risk increases to 1 in 7,500 for women. That is more in line with what I expected.

This is just people with a diagnosis of those two types of venous clots. This is all populations, not just those on birth control.

When the CDC combines the numbers for DVT and PE 1-2 people out of 1,000 will have a clot. (1 in 100 for those over 80!) This is males and females combined. That may be the number that you have seen that you mentioned in your comment.

60,000-100,000 people die each year in the US from these clots. Those of us who survive have a 33% chance of having another clot in the first 10 years. (That gives me about 6 years to go until I have cleared that number.)

Thanks again for reading. I know you are scared! I hope some of those numbers help clarify things. I also hope that the extensive information that I have provided on non-hormonal birth control is very useful to you. If you know of any methods that I have missed, please let me know so that I can add them. My main focus on this hub is to make sure that people know the risks of birth control and can understand some of the alternatives to hormonal contraception.


Julie 3 years ago

What about natural progesterones; creams/sprays? Any increase in clots with those?


Lwelch profile image

Lwelch 3 years ago from USA Author

Being that even the progesterone that your body produces can induce clots (the clot risk skyrockets during and after a pregnancy) I would say yes. Ask someone who knows more than me though! I am not a health professional.

I would also recommend that you read above about progesterone only so you have some ideas about what to ask a doctor. Many studies show progesterone only to be fine, but there are stories of people who clot on progesterone only.


becca 3 years ago

I was on the birth control pill "apri" for 4 years and ended up having a pulmonary embolism at age 21 (non-smoker and no history of blood disorders) I am aware how very rare of an occurrence this was - but you never know how the pill will affect you, probably not even aware that you could be risking your life.


Lwelch profile image

Lwelch 3 years ago from USA Author

It can be scary how medications can affect us. Aspirin can cause hearing loss or, in a child, severe illness and death.

Do your research so that you can make an informed choice and so that you can know what to look out for. If you know the dangers you may call the doc sooner rather than later and save your body from further damage.

For those who have clotted or have a family history of clotting - share this knowledge with your offspring. It may save them the pain you are in.

If you need help healing, check out all of my hubs on clotting - there are a ton now. Feel free to email me with questions.


REMY 3 years ago

I was on Depo for years without complication. I switched to Yasmin for a couple years and developed multiple DVTs. I hate not being on birth control, as I have no intention of ever having children, and especially since prior DVT increases the risks if I were to ever get pregnant. What could I take?


Lwelch profile image

Lwelch 3 years ago from USA Author

I would talk to your doctor about a few things. First, you could look at progesterone only contraception. The WHO and many USA doctors feel that progesterone only hormonal contraception is safe. The new Skyla IUD is over 99% effective, has no blood clot contraindications, and is over 99% effective. It is good for 3 years. Mirena is a higher dose IUD and is good for 5 years. The copper IUD is another option. No hormones, heavier bleeding, 99% effective. The mini pill is much less effective but is an option. Also, any type of tubal ligation procedures will work and are permanent. They do raise the risk of clotting though for a while after surgery. I would print out the article and hand it to your doc and ask your doc to circle the ones that he or she is comfortable with.


Amanda 19 months ago

Hi! Do you have any advice for a young woman (26) that has had a pulmonary embolism after child birth that hadn't been on birth control 3 years prior to embolism? I started my cycle young (12) at 13 I started to take the pills to help regulate my cycle. I would be on my cycle 3 weeks and off for 1. I took bc pills from 13 to 18. I stopped because my fiancée (at the time) and I had wanted a child. We tried for two years. Nothing! A year after he and I stopped I was in a relationship with another man. When we decided to have a child we conceived right off the bat. I had my son in 2008. 7 days exactly after we took our baby home I had awful pain in my neck when I swallowed. I breast fed so I ate before and after. It became to painful for me to eat. I decided I needed to get to the doctor. I was scared to death and knew something was wrong. I was 20. I had a 7 day old baby and a Pulmonary embolism and I was told I was lucky to be alive. The doctor couldn't believe I was standing in front of him. I was placed in the hospital. I was on anticoagulants for 2 years. My first gyn gave me the mirana. I changed obgyns and the second took it out and gave me the paragard. I've had it for 7 years in June. My cycle goes for 14 days. I don't mean just a normal nice flowing cycle. I wear a super plus tampon and pad pretty much the whole time. If I don't change them in an hour, I bleed through. My doctor tells me this is normal. I don't understand how. It's 7 days short of when I was younger and needed my cycle regulated. I have horrible cramps and I am soooo tired of seeing my aunt flow so often! Any tips or ideas to help will be MUCH APPRECIATED!


Lwelch profile image

Lwelch 19 months ago from USA Author

HI Amanda - ask about the progesterone only IUDs. The newer, smaller one states in the prescribing info that it is appropriate for someone with a history of clots. Its name is Skyla. Mirena has more progesterone and may not be appropriate. That being said, studies have not found a link between clots and progesterone when used in the amounts in birth control. You can go to https://managingcontraception.com/ and ask the medical doctors at that site about both options. They will get back to you. Just send them the same note that you left here. You can also ask your OBGYN and hematologist for an opinion. If you get the same answer from multiple sources you will be confident in your decision.


lyoness913 profile image

lyoness913 16 months ago from Overland Park, KS

What an excellent, informative hub. My hope is that many women find this and use the tremendous amount of resources you have here. I have pinned it. Great article!


Lwelch profile image

Lwelch 16 months ago from USA Author

Thank you!


JM 16 months ago

I had shoulder surgery and 4 days later I couldn't extend my arm at the elbow. I went I my surgeon and had ultra sound. I have a DVT in my arm at my elbow from the surgery. I've taken bc for 25 yrs with no problem. Now I'm on Warfarin for 3 months then they will ultra sound to see if clot is gone. If gone I stop Warfarin, if not I continue. I just had my yearly with my OB, she said no more bc, but wants me to start the progesterone only bc ( mini pill). I remember trying a mini pill after by son was born while breast feeding (19yrs ago) it caused severe cramping and stomach pain, I ended up at Urgent Care. I'm going to be 50 this year. Next year my OB will take me off bc due to age. I am flying to Hawaii for my 25th anniversary and switching everything around is scary and frustrating. My body is VERY sensitive to meds and changes. Before bc, I would only have periods 1-2 times a year. I've had night sweats and hot flashes for a few years now, but not so much this year. I'm ready to stop bc all together and just use condom. How effective is that? I just want a romantic anniversary. Advice???


Lwelch profile image

Lwelch 16 months ago from USA Author

Condoms have been considered to be the best after the pill. It does sound like bad timing! Your OB can give you exact numbers for effectiveness and perhaps you could use a back up like a diaphragm so that you have two forms at work. Also, this sounds silly but I would practice before the anniversary. It would be awful to have a bad experience on your trip!


Jordan 14 months ago

Hi! Recently diagnosed with DVT and PE. I'm 19, I was taking the pill, but we think it was caused more from my ankle sprain, not putting pressure on it and taking a road trup. They took me off and of course can't take them again. I'm looking for a new option. I really wanted the implant but everywhere I read it says don't take it if you have or had blood clots. Yours doesn't. My next option is Skyla. Not Mirena, I've heard bad things, many lawsuits and I've never had a kid.


Lwelch profile image

Lwelch 14 months ago from USA Author

The WHO gives Implanon a favorable rating (a 2) for people with a history of clots. I recommend that you go to a really cool website and ask a doctor your question for more information. The website is called "Managing Contraception". I can't include links easily in comments but if you search that you should find it. Once there go to the Q&A section. You can submit your question to a medical doctor. I did that with my questions. You can also search for "pulmonary embolism" I know that this post: "What is the safest form of contraception for my patient? She is a 20 year old nulligravid who has DVT, pulmonary embolism (PE), and Factor V Leiden deficiency. #1170/7" has information about the WHO's thoughts on implants.

I see that all of the progestin only methods have the disclaimer about clots. I even think Skyla has it somewhere in the packaging. IUDs are very safe these days. There are a ton of lawsuits out there! It is difficult to tell who is fishing for money or clients and when a medical lawsuit is reason for concern. I love that you are thinking about that and not just hitting a panic button! IUDs are fine if you have never had a baby. Your body may decide to spit the thing out as your uterus is smaller. The Skyla is smaller and better suited for those who haven't had a baby. The name for that is nulliparous. If you see that word on managing contraception that is what it means. The insertion also may have more cramping.

When I did my research I wrote to the doctors at Managing Contraception, spoke to my GP, spoke to my OBGYN, and spoke to my hematologist. All four agreed that the copper Paraguard or the Mirena would be an acceptable risk with my Factor V Leiden and history of pulmonary embolism. Why don't you do that interview with your medical team and see what they say.

Again, keep up the great thinking! Feel free to send me a private message at The Clot Spot! (also searchable and easy to find.)

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