General Warnings

Taking Painkillers While on Birth Control Pills Increases Your Risk Of Blood Clots – New Study

Blood clots, medically known as thrombosis, pose a significant health concern and can lead to severe complications if left untreated. They can form in veins (venous thrombosis) or arteries (arterial thrombosis) and may cause conditions like deep vein thrombosis (DVT) or pulmonary embolism (PE). While various factors can contribute to blood clot formation, certain medications can also influence this risk.

The formation of blood clots is influenced by a combination of factors, including genetics, underlying medical conditions, and lifestyle choices. These risk factors can include a family history of clotting disorders, prolonged immobility, smoking, obesity, and certain medical conditions like cancer and autoimmune diseases. Additionally, major surgeries and trauma can elevate the risk of clot formation.

Several medications can impact blood clot risk. Hormonal treatments, such as birth control pills and hormone replacement therapy, can slightly increase the risk of clot formation due to their effect on blood clotting factors. Similarly, some cancer treatments, including chemotherapy and certain targeted therapies, can raise the risk of clotting. Additionally, medications like erythropoiesis-stimulating agents (used to treat anemia) and some immune-modulating drugs have been associated with clotting events.

It is a well-established fact that certain forms of birth control carry a slight risk of blood clots. However, a recent extensive study involving 2 million Danish women has revealed a new dimension to this issue, suggesting that common painkillers can potentially amplify this risk.

This comprehensive study confirmed what several previous ones had found: women who used birth control pills or other contraceptives containing estrogen faced an increased risk of developing blood clots in their legs or lungs. However, the researchers unearthed an additional layer to this connection. They discovered that the risk of blood clot formation was further heightened during weeks when these women also used nonsteroidal anti-inflammatory drugs (NSAIDs), which include familiar painkillers like ibuprofen and naproxen.

It is essential to emphasize that, for any individual woman, the risk of experiencing a blood clot remains quite low. Dr. Colleen Denny, the director of family planning at NYU Langone Hospital Brooklyn, believes that women using hormonal birth control need not worry about using NSAIDs for short-term pain relief. In fact, in some cases, an NSAID may be the most suitable option for pain management.

Moreover, it’s crucial to maintain perspective regarding the blood clot risk associated with birth control. This risk is considerably lower than the odds of developing a clot during pregnancy or shortly after giving birth.

The study encompassed various hormonal contraceptives such as birth control pills, rings, patches, and certain intrauterine devices (IUDs), all of which utilize hormones to prevent pregnancy. Some of these contraceptives, especially those with higher levels of estrogen, have long been linked to a slight increase in the risk of blood clots. This is because estrogen can elevate blood levels of specific proteins that contribute to clot formation.

Conversely, NSAIDs have also been associated with an increased blood clot risk. However, until this study, there was limited knowledge about whether using both birth control and an NSAID simultaneously would amplify this risk. The study, published in the journal BMJ, examined medical records from 2 million women aged 15 to 49 living in Denmark between 1996 and 2017. During this period, over 8,700 women experienced a first-time venous thromboembolism, which is a blood clot either in a leg vein or in the lungs.

The study revealed that NSAID use alone was linked to an elevated blood clot risk compared to periods when women did not use these painkillers. Similarly, the risk was higher among women who used estrogen-containing birth control alone. However, when both were used simultaneously, the risk of blood clots notably increased. It’s important to note that while the risk was larger when the two were combined, the absolute risk of venous thromboembolism remained low for women using both drugs.

To put it in perspective, the study estimated that approximately 4 out of 100,000 women would develop a blood clot per one week of NSAID use. For those using “high-risk” contraceptives, such as estrogen/progestin patches, rings, or pills with high estrogen doses (50 micrograms), around 2 in 100,000 would develop a clot per week of use. However, when women combined high-risk contraceptives with an NSAID, an estimated 23 of 100,000 would develop a blood clot per week of use. NSAIDs had a lesser impact on women using “medium-risk” contraceptives, such as other birth control pills, with an estimated 11 of 100,000 developing a blood clot per week of NSAID use. Notably, painkillers had no apparent effect on blood clot risk among women using “low-risk” contraceptives like progestin-only pills and IUDs.

Although blood clots are a rare complication associated with some contraceptives, they can be severe. Dr. Amani Meaidi, the study’s lead researcher, advises that women who frequently require NSAIDs for pain management may want to consider opting for a low-risk form of birth control.

For women in the process of choosing contraception, Dr. Denny suggests that doctors already screen for risk factors that could increase the likelihood of a blood clot, such as smoking or a history of blood clots. However, any woman with concerns about blood clots can explore low-risk contraceptive options like an IUD or progestin-only pills. Fortunately, there are numerous contraceptive choices available to suit individual needs and minimize potential risks.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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