In light of the recent news coverage of the risks of blood clots with the Astra Zeneca vaccine and the shift in social media debates from the AstraZeneca jab to hormonal contraceptives, we asked MSI UK’s Lead Contraceptive Nurse - Julia Hogan - to explain the possible risks associated with the use of the combined contraceptive pill.
The combined pill is a daily tablet that contains two hormones, progestin and oestrogen, which are similar to hormones in your body.
The hormones prevent an egg from being released by the ovaries each month and make it harder for sperm to get into the uterus (womb).
The pill needs to be taken once a day for three weeks and then you can have a week’s break to have a period, or you can continue to take the pill every day to avoid having a period.
To learn more about how the contraceptive pill works read our latest blog: “The combined pill: what it is and how it works”.
What are the risks associated with the combined contraceptive pill?
The contraceptive pill is often the first method women will ask for. It is easy to use and you can stop and start whenever you like without the need to see a healthcare provider. It can also provide benefits such as lighter, predictable periods and improved acne.
Combined hormonal contraceptives are very safe for most women to take. Some of the rare risks associated with combined contraceptive methods include the development of a blood clot in your leg or lungs, a heart attack, or a stroke. This very small increased risk of venous thrombosis (VTE) with use of the combined pill is far lower than the risk during or after pregnancy.
It is also important to note that the Progestin-only Pill (POP) does not carry the same risk. You can read more about the "mini-pill" at this link: "The progestogen-only pill or the mini-pill: everything you need to know".
The benefits of taking the combined pill outweigh the possible risks, but it is essential that all our patients have access to quality advice and information when it comes to contraception.
For anyone with higher risk factors, there are alternative oral contraceptives which give no increased clotting risk and suit most very well. The essential element is that contraception and quality advice are readily available. Being able to access this - and having the really effective and convenient long-acting reversible methods available without a long wait - is where the priority should lie.
Is the risk of developing blood clots from the pill higher than it is with taking the AstraZeneca vaccine?
Comparisons with the AstraZeneca jab are unhelpful. The contraceptive pill is very safe for most people to take and the benefits far outweigh any risks. I would advise anyone worried about possible side effects from the contraceptive pill to seek advice from their GP before discontinuing, not least as there is a far larger risk of blood clots during and after pregnancy. For more information about the different contraceptive options visit MSI’s digital contraceptive counsellor.
It is well documented that use of combined hormonal contraception is associated with a small increased risk of venous thrombosis, but all contraception including the combined oral contraceptive pill is safer than being pregnant. Developing a clot is a rare event but a woman is five times more likely to develop a clot when pregnant than when on the pill.
However, too many women are still being let down by a lack of contraceptive choice, education and access. For anyone with higher risk factors, there are many alternatives, which give no increased clotting risk and suit most very well.
Being able to access this - and having the really effective and convenient long-acting reversible methods available without a long wait - is where the priority should lie.
Do you have concerns about the prescription of the contraceptive pill- is it over prescribed?
As long as women are informed and have access to the full range of methods, the number being prescribed the pill is not a concern. However, today accessing the most effective long acting methods, like the implant and coil can be challenging. It is essential that advice and access to contraception, including long-acting reversible methods are readily available without a long wait. That is where the priority should lie.
Would you like to see anything change when it comes to prescribing contraception?
We would like to see the reclassification of the progestin-only pill so it can be sold directly to women without a prescription by a pharmacist. This would help improve access to an extremely safe method of contraception and give women another option if they cannot access their GP or prefer a walk-in service. The only concerns about this are the cost because in the UK contraception is free, so it would be a shame if this initiative stops women that can’t afford the POP accessing it.
VIDEO: The combined contraceptive pill
In this short video, we share all you need to know about the combined contraceptive pill, including how to use it, how effective it is, advantages, disadvantages and risks.
"CHOICE": MSI UK's digital contraception counsellor
At MSI UK, we believe that the essential element is that contraception and quality advice are readily available. This is why we have developed “Choice” our digital contraception counsellor in order to offer personalised contraceptive advise to anyone using the platform: you can go through a questionnaire to find out which contraceptive methods is most suitable for you based on your needs and circumstances.
For more information about the different contraceptive options visit MSI’s digital contraceptive counsellor by clicking here.
We would advise anyone worried about possible side effects from the contraceptive pill to seek advice from their GP before discontinuing, not least as there is a far larger risk of blood clots during and after pregnancy.
- For more information on who can use the combined pill, you can visit the NHS website here: Combined pill: Your contraception guide
- The Faculty of Sexual and Reproductive Healthcare (FSRH) released a statemen you can read at this link: "Cerebral venous sinus thrombosis AstraZeneca COVID-19 vaccination and CHC"
- To read more on the mini-pill, follow this link: "The progestogen-only pill or the mini-pill: everything you need to know"
- To learn more about how the contraceptive pill works read our latest blog: “The combined pill: what it is and how it works”.