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What is the risk of blood clots?
The combined pill can slightly increase the risk of blood clots, but for most healthy people the chance is still low. Blood clots can form in a vein, usually in the leg, and in rare cases they can travel to the lungs. This is why the issue gets attention, even though serious problems are uncommon.
It is important to remember that the pill is not the only thing that can raise clot risk. Smoking, being overweight, a family history of clots, some medical conditions and long periods of immobility can all play a part. Your overall risk depends on a mix of factors, not just contraception alone.
Who should be more cautious?
Not everyone needs to worry in the same way. People who have had a blood clot before, or who have certain clotting disorders, may be advised to avoid the combined pill. Doctors may also be more careful if you are older, smoke, or have migraine with aura.
The risk can also be higher in the first year of using the pill, or after restarting it following a break. If you have had a recent operation, are recovering from an illness, or are less mobile than usual, your clinician may suggest a different method. This is one reason it is worth discussing your full medical history before starting.
What about the progestogen-only pill?
The progestogen-only pill, often called the mini-pill, does not carry the same clot risk as the combined pill. For many people, it is a safer option if they have concerns about blood clots. Other non-oestrogen methods, such as the implant or hormonal coil, may also be suitable.
That said, every method has pros and cons. The best choice depends on your health, your lifestyle and how well you want it to fit into your routine. A GP, nurse or sexual health clinic can help you compare options.
When should you seek help?
Knowing the warning signs is important. Get urgent medical help if you develop swelling, pain or redness in one leg, sudden shortness of breath, chest pain, or coughing up blood. These symptoms need prompt assessment.
If you are worried about your pill, do not stop taking it abruptly without advice unless a clinician tells you to. Speak to your GP, pharmacist or sexual health service as soon as you can. They can check your risk and help you choose the most suitable contraception.
Frequently Asked Questions
Blood clots when taking the pill are clots that can form in a vein or, more rarely, an artery while using hormonal birth control. Some pills, especially those containing estrogen, can slightly increase clotting risk because estrogen can make the blood more likely to clot.
Blood clots when taking the pill are most strongly associated with combined oral contraceptives that contain both estrogen and progestin. Progestin-only pills generally have a much lower clotting risk than combined pills.
Blood clots when taking the pill are uncommon, but the risk is higher than it is for people who are not using estrogen-containing contraception. The absolute risk for most healthy users is still low, but it increases with other risk factors such as smoking, obesity, or a prior clot.
Warning signs of blood clots when taking the pill can include one-sided leg swelling or pain, chest pain, shortness of breath, sudden severe headache, vision changes, or weakness on one side of the body. These symptoms need urgent medical attention.
If you think you have blood clots when taking the pill, seek emergency care right away, especially for chest pain, trouble breathing, or stroke-like symptoms. Do not wait to see if symptoms improve.
People at higher risk for blood clots when taking the pill include those over 35 who smoke, people with a personal or family history of clots, those with obesity, recent surgery, prolonged immobility, certain inherited clotting disorders, or a history of migraine with aura.
Yes, blood clots when taking the pill can happen in young healthy people, although the risk is much lower than in people with major risk factors. Even so, any new symptoms of a clot should be taken seriously.
Blood clots when taking the pill can occur within the first few months of starting, but they can also happen later during continued use. The risk is often highest in the early months after beginning an estrogen-containing pill.
Stopping the pill removes the added clotting risk from that medication, but it does not immediately treat an existing clot. If a clot is suspected, urgent medical evaluation and treatment are needed.
Blood clots when taking the pill cannot be completely prevented, but the risk can be reduced by choosing a lower-risk method when appropriate, avoiding smoking, staying active, and discussing personal risk factors with a clinician before starting hormonal contraception.
Progestin-only pills are generally considered safer than combined pills for blood clots when taking the pill because they do not contain estrogen. However, your overall medical history should still be reviewed before choosing any contraceptive.
Yes, blood clots when taking the pill can lead to a pulmonary embolism if a clot from the leg travels to the lungs. This is a medical emergency and often causes sudden shortness of breath, chest pain, or coughing up blood.
Blood clots when taking the pill can rarely contribute to arterial clots, which may cause a stroke or heart attack, especially in people with other risk factors. Sudden facial droop, arm weakness, speech trouble, or chest pressure require emergency care.
If you are worried about blood clots when taking the pill, contact a clinician promptly to discuss your symptoms and risk factors. Do not ignore possible clot symptoms, but also do not make changes without medical advice unless you need emergency care.
Yes, blood clots when taking the pill can be diagnosed with tests such as ultrasound for leg clots, CT scans for lung clots, and sometimes blood tests or other imaging. The exact test depends on the symptoms and suspected location of the clot.
The long-term effects of blood clots when taking the pill depend on where the clot occurred and how quickly it was treated. Some people recover fully, while others may have chronic pain, swelling, lung problems, or a higher chance of future clots.
Yes, many people can use non-estrogen birth control methods after blood clots when taking the pill, such as a progestin-only pill, copper IUD, or certain other methods. A clinician should help choose the safest option based on your clot history.
Yes, smoking increases the risk of blood clots when taking the pill, especially in people over 35 using estrogen-containing pills. Smoking also raises the risk of heart attack and stroke with combined hormonal contraception.
Yes, blood clots when taking the pill can be influenced by the estrogen dose and the type of progestin in the pill. In general, lower estrogen doses may have a lower clotting risk, but the risk is not eliminated.
Seek emergency help for blood clots when taking the pill if you have sudden shortness of breath, chest pain, coughing blood, one-sided leg swelling or pain, sudden severe headache, weakness, numbness, or trouble speaking. These can be signs of a dangerous clot or stroke.
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