Do Genes or Birth Control Cause Blood Clots?

Each few months, the capsule and the ring hit the headlines for growing the danger of blood clots in some ladies. Well being care professionals know this isn’t actually information—the hyperlink between sure contraception strategies and elevated danger of blood clots is nicely-established. Well being care professionals additionally know that a bunch of different elements improve the danger for blood clots too. Along with use of mixed hormonal contraceptives just like the capsule, ring, or patch, issues like smoking, having surgical procedure with a forged or mattress relaxation, weight problems, and genetic elements can all improve a lady’s danger of forming a blood clot.

Till now, it’s been unattainable to say how necessary every of those elements is on their very own. The times of idle hypothesis are ending: A brand new research from Sweden in contrast 948 ladies who had blood clots to 902 who didn’t and thought of every of those elements.

It is determined by the progestin

The brand new research confirmed what different research have proven—that the danger of a blood clot is totally different relying on what sort of hormonal technique a lady makes use of.

Not all drugs are created equal. In comparison with ladies utilizing contraception tablets containing the progestin hormone levonorgestrel, ladies utilizing drugs containing the progestin desogestrel have been over two occasions extra more likely to have a blood clot. (FYI, tablets bought within the U.S. that include desogestrel embrace Kariva, Mircette, Mercilon, Desogen, Ortho-Cept, Apri, Solia, Cyclessa, Velivet, and Cesia.)
No estrogen? No elevated danger. The research additionally confirmed that utilizing most progestin-solely contraception just like the mini-capsule, implant, and hormonal IUD was not associated to blood clots.
With one essential exception. The exception was the shot. In comparison with ladies utilizing a hormonal IUD, ladies utilizing the shot have been 3 times extra more likely to have a blood clot.

However genes are much more necessary

The research additionally checked out ladies’s DNA to see if that they had any mutations associated to blood issues that trigger clotting, a.okay.a. thombophilc mutations. They discovered that two gene mutations, Issue V Leiden and prothrombin, have been strongly associated to having a blood clot.

Issue V Leiden mutations: In comparison with ladies with out the Issue V mutation, these with this gene have been 2.6 occasions extra more likely to have a blood clot—even once they weren’t utilizing hormonal contraception of any sort. Once they added a mixed hormonal contraception, they turned 20 occasions extra more likely to have a blood clot.
Prothrombin mutations: In comparison with ladies with out the prothrombin mutation, these with this gene have been no extra more likely to have a blood clot than different ladies. Nevertheless, when ladies with this mutation added a way of mixed hormonal contraception, they turned 17 occasions extra more likely to have a blood clot.

When the researchers did the identical calculations with out ladies who have been overweight or who had current surgical procedure or a forged, they discovered that these genetic mutations have been much more strongly associated to blood clots.

Genetic check? Costly. Household historical past? Free.

Within the U.S., between three% and eight% of individuals carry at the least one copy of the Issue V Leiden gene mutation, and between 1% and a couple of% carry the prothrombin mutation. The one option to know for positive when you’ve got one among these genes is to get a DNA check. In the event you don’t have the money for a check, nature provides us a useful various: household historical past. In one other research, the identical analysis workforce discovered that having a member of the family who has had blood clots was additionally a great way to foretell who may develop blood clots when utilizing the capsule, patch, or ring.

The excellent news? Even ladies with the genes that carry the very best danger of blood clots can safely use any IUD, the implant, or the mini-capsule.