In the last few weeks, as reports on the very rare blood clotting side effect of the AstraZeneca vaccine continued, many women have been rightly pointing out the risks of blood clots associated with the contraceptive pill are much higher – and yet no one has seemed to care about that for decades.
Now, the risks of developing a blood clot with the contraceptive pill is still ‘very small’, according to The Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists (RCOG). However, the commentary online has forced many to ask, will being on the pill compound the risk of blood clots when I actually get the vaccine?
It’s worth noting that under-30s will be offered an alternative to the AstraZeneca vaccine when they get their jabs – if available – however women in their 30s are then left wondering, what about us?
So far, a review by the Medicines and Healthcare products Regulatory Agency (MHRA) found that of 20 million doses administered, there were 79 cases of blood clots and 19 deaths – nearly two thirds of the cases were in women and of the 19 who died, three aged under 30.
While the risks are low, the combination of fears around the vaccine and resurging of worries about the contraceptive pill has caused many to ask: 'Should I come off the pill when I get my vaccine?'
It’s a valid question, if all you’ve seen is people talking about how high the blood clot risk if for combined hormone contraceptives compared to the vaccine you’re bound the worry about both being on the pill and having the vaccine at the same time. But according to the experts, you don’t need to.
According to the FSRH, the specific type of blood clot associated with the AZ vaccine is unusual and they don’t know that the risk associated with the pill – which they refer to as CHC, combined hormone contraceptive – affects that type of blood clot.
We do not recommend that combined hormone contraceptive users stop their contraception when they receive their first or second COVID-19 vaccine.
‘We do not recommend that CHC users stop their contraception when they receive their first or second COVID-19 vaccine,’ states the FSRH. ‘The specific type of thrombosis with thrombophilia reported after AstraZeneca COVID-19 vaccination appears to be idiosyncratic and we don’t know that it is affected by combine hormone contraceptive-associated thrombotic risk.’
They also state that the risk of blood clots with CHC’s persist after coming off the pill, so stopping right before you get the vaccine won’t make much of a difference to your risk levels. What it will do, however, is increase your risk of unplanned pregnancy which as you may have noted online, pregnancy in turn has a higher risk of blood clots than taking the pill.
‘In any case, increased risk of thrombosis is likely to persist for some time after stopping CHC, therefore stopping immediately before vaccination is unlikely to significantly reduce thrombotic risk,’ the FSRH advice reads. ‘Stopping CHC around the time of vaccination without switching to alternative effective contraception could put users at risk of unplanned pregnancy with its associated risk of thrombosis, and at higher risk of thrombosis when CHC is restarted.’
Ultimately though, the risks of Covid-19 outweigh any risks of blood clots whether you’re on the pill while getting the vaccine or not.
‘Having the COVID19 vaccine protects against COVID19 infection and the very serious health problems that it causes – including thrombosis and many others,’ the advice continues. ‘If someone delays their vaccine, they stay at risk of those serious health problems for longer. Based on what we know, we recommend that people, including combined hormonal contraception users, attend for their COVID19 vaccination when it is offered, and do not delay it to wait for a specific type of vaccine.’
They do however, state that if this commentary has increased your concern about blood clot risks, it’s worth talking to your GP or sexual health service provider about your options.
‘Of course, if people want to switch to a different method of contraception because they do not want to be at increased risk of thrombosis in the future, they can do that,’ the FSRH conclude. ‘As a precaution, after their vaccine, people should look out for any symptoms of blood clots like persistent headaches, breathlessness, coughing up blood, swelling of a leg or severe abdominal pain.’
The British Pregnancy Advisory Service (BPAS) agree, in fact they’ve become increasingly concerned that the conversations around blood clots and the pill could lead to another ‘Pill Scare’ that increased unplanned pregnancies back in the 90s.
‘It is vitally important that discussions comparing the risks of blood clots associated with the AstraZeneca COVID-19 vaccine with those of the contraceptive pill do not pave the way to a repeat of the 1995 “Pill Scare” which led to a significant increase in unplanned pregnancies,’ their statement reads. ‘Nothing is risk free but these are both safe medical technologies, and the risks and benefits of both need to be evaluated within an individual context.
Women should be informed of the risks associated with all methods of contraception, but these risks must be kept in perspective.
‘Combined hormonal contraceptives (CHC) are overall very safe for most women to take - the very small increased risk of venous thrombosis (VTE) with use of the combined pill is far lower than the risk for VTE during or after pregnancy,’ it continues. ‘As part of the contraceptive counselling process, women should be informed of the risks associated with all methods of contraception, as would be expected with any prescription medication, but these risks must be kept in perspective.
‘A review of the risks of the combined pill by the Medicines and Healthcare Regulatory Authority, the MHRA, in 2014 confirmed that the benefits of any combined hormonal contraceptive far outweigh the risk of serious side effects.’
They state that while it’s important to reassure the public about the safety of the AZ vaccine, that shouldn’t come at the expense of heightening fears around the pill. ‘We advise that any woman who is concerned about their current method of contraception seeks advice from their GP before discontinuing,’ BPAS concluded. ‘An unplanned pregnancy presents a greater risk of VTE than the use of the combined hormonal contraception. Any woman who has a pregnancy she knows she does not want to continue should be able to access abortion care as swiftly as possible.’
Read More:
Yes, The Contraceptive Pill Is Much More Likely To Cause A Blood Clot Than The AstraZeneca Vaccine