Birth Control and Blood Clots: What You Need To Know

The recent pause of the Johnson & Johnson (J&J) COVID-19 vaccine over its link to blood clots sparked heavy discussion on social media, comparing it to the risk of blood clots when taking hormonal birth control. To get the facts straight, we spoke with women’s health expert Dr. Jennifer Stuck of Paoli OB/GYN, who shared what women need to know about the risks and benefits of hormonal birth control.

Before we dive into our discussion with Dr. Stuck, let’s review what we know so far about these recent COVID-19 vaccine events from the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC).

COVID-19 Vaccine and Blood Clots in Women

On April 13, 2021, the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention recommended a pause on the J&J COVID-19 vaccine after six women, between the ages of 18 and 48, experienced severe blood clots. These were six women out of the 6.8 million people who had then received the vaccine.

These women developed what is known as cerebral venous sinus thrombosis (CVST), an extremely rare, but dangerous type of stroke caused by blood clotting in the brain.

After a nearly two-week pause and further assessment by the Advisory Committee on Immunization Practices, on April 23, 2021, the CDC recommended that the U.S. resume use of the J&J COVID-19 vaccine, declaring that the benefits outweigh the risk. The CDC and the FDA acknowledge the pause as a precautionary measure, and are continuing to closely monitor for any adverse events, as safety remains of utmost priority.

There has been no evidence that oral contraceptives increased risk of blood clots, in the specific case of the J&J vaccine.

So how do the J&J occurrences stack up to the risk associated with hormonal contraceptives? Overall, experts agree you can’t make a direct comparison as the causes and type of blood clots can be quite different.

Let’s learn more in our interview with Dr. Jennifer Stuck.

Hormonal Birth Control and Blood Clot Risks: Interview with Dr. Jennifer Stuck

1. Dr. Stuck, what is my risk of developing a blood clot with birth control?

Overall, the pill is seen as a very safe and effective form of birth control. It’s 99% effective at preventing unwanted pregnancy when taken as directed, each time, each day. However, as with many medications there is a risk of side-effects.

Between three and nine out of every 10,000 women who take oral birth control pills will develop a blood clot, according to data from the FDA. In other words, it’s a small 0.3% to 0.9% risk.

Now, not all birth control carries this risk. Specifically, it’s the hormone estrogen found in the pill that has been linked to blood clots that developed in women’s legs, also known as deep vein thrombosis (DVT). While DVT itself is not life-threatening, it can pose a greater risk if the blood clot breaks off and travels to other areas such as your lungs (known as a pulmonary embolism).

2. What are some potential warning signs of a blood clot?

If you are experiencing redness, pain, and swelling in the back of the calf, as well as shortness of breath and chest pain, these could be potential warning signs of a blood clot. If you’re experiencing any of these symptoms, you should contact a medical professional immediately to have it assessed.

3. Are certain women more at-risk for blood clots?

Yes, certain women may be more at-risk for developing blood clots if they have a family history of deep vein thrombosis (DVT) or pulmonary embolism. Additionally, obesity and smoking tobacco can increase your risk, especially if you are over the age of 35.

4. How will I know what form of birth control is right for me?

Your provider will always review your family history before prescribing any form of birth control to better understand your potential risk factors and determine the best treatment option for you. Luckily, there are many hormonal and non-hormonal options available to best suit your needs.

Bottom Line

While it’s important to understand any potential risks associated with a medication, experts agree the probability of developing a serious blood clot from either the COVID-19 vaccine or hormonal birth control are rare. There is no evidence to suggest that women should stop taking birth control if they are getting the J&J vaccine.

Because each woman’s risk for blood clotting is dependent on her personal family history and lifestyle factors, it’s always important to share these considerations with your provider when starting a new medication.