Caution with contraception

Genetics and smoking: the pill increases the risk of thrombosis

Get genetically tested before taking the pill!

(Bild: stock.adobe.com/megaflopp)

With this type of contraception, blood clots are more likely to occur. These can block a blood vessel. A number of other factors also increase the risk of thrombosis. Anyone with a family history of such illnesses should definitely tell their doctor and look for alternatives.

In general, gynecologists are seeing a trend towards hormone-free contraception among young women. At the same time, many of them take the pill without hesitation, without paying attention to the fact that they are overweight or smokers, for example.

Stop smoking!
Smoking in particular poses a high risk of thrombosis. These can then lead to leg vein thrombosis or pulmonary embolism.

Other factors for such a (sometimes life-threatening) disease are too many kilos (from BMI 30), an age of over 35 years or prolonged immobilization (bed rest, sitting for more than four hours, caution when travelling!). Diseases such as high blood pressure, diabetes or high cholesterol levels can also maximize the risk.

In general, taking the contraceptive pill increases the risk of thrombosis about fourfold.

Priv. Doz. DDr. Stefan Wöhrer, Gesundheitszentrum „Permedio“ in Neunkirchen (NÖ

Caution also applies to those who have already had a thrombosis. Even if this condition has already occurred in family members, experts advise against taking the pill. There are also congenital blood clotting disorders that are often unknown.

Congenital coagulation disorder
These are often only discovered when the first blockage of a vessel by a clot occurs, such as the rare coagulation disorder APC resistance. The most common cause of this in Europe is the factor V Leiden mutation. This is a genetic change in blood coagulation factor 5, which leads to an increased incidence of excessive coagulation and the development of thromboses.

The risk of thrombosis varies depending on whether there is one (heterozygous) or two (homozygous) changes in factor 5. If there is only one genetic alteration, the risk increases fourfold; if there are two genetic alterations, the risk increases twelvefold. It is estimated that around five percent of all Europeans have to reckon with such a genetic change.

Nicotine products are also harmful

• Even if e-cigarettes or nicotine pouches contain fewer harmful substances than conventional cigarettes, the nicotine they contain triggers the same reactions in the body as nicotine products containing tobacco.
• This harmful substance can constrict the blood vessels and affect clotting. Nicotine (and other chemicals) promotes the activation of blood platelets (thrombocytes), which promotes the formation of thrombi.
• In the long term, the vasoconstrictive effect of nicotine could therefore promote diseases such as heart attacks or strokes, experts are certain on the occasion of the recent World No Tobacco Day.

"In general, taking the contraceptive pill increases the risk of thrombosis by around four times. However, if a patient who has a factor V disorder chooses this type of contraception, her risk increases 35-fold," explains internist Priv. Doz. DDr. Stefan Wöhrer, "Permedio" health center in Neunkirchen (Lower Austria). "It is therefore best to test all patients for factor V Leiden before starting the pill in order to avoid a thromboembolic event. Many doctors already carry out this test routinely."

Specialist clarifies
As a general rule, you should consult a gynecologist if you have any questions about the pill. They should explain the advantages, disadvantages and side effects of hormonal contraception. For women who cannot or do not want to use hormonal contraception, there are alternatives such as copper chains, balls, IUDs or gold IUDs.

Tip for summer vacation flirtations: "She" should have condoms with her if spontaneous sex could occur in order to avoid sexually transmitted diseases - regardless of whether another contraceptive method is used.