birth control blood clot

Brain Bombs: Survivors’ Stories of Birth Control Induced Strokes

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What does it feel like to have a stroke? We have all seen TV re-enactments of stroke and some of us have had the unfortunate opportunity to witness a stroke first hand, but few of us have any real sense of what a stroke feels like in the moments before it happens. Over the last several months, we have been investigating the early warning signs of birth control induced blood clots. Stroke survivors represent the largest group within our study so far. Their stories tell us a lot about the early warning signs of birth control induced strokes. Full stories can be read here, but since few have had any experience with stroke, especially birth control induced strokes, we thought it was important to highlight the key patterns.

Does It Hurt?

One of the more interesting questions, is there pain associated with a stroke? In some cases no, the stroke appears to come out of nowhere. In other cases, there is a clear progression of head pain in the weeks, days, and hours leading up to the event.

From no pain:

Right before the stroke – I was just really tired and crabby I went to take a shower and all of a sudden I felt really dizzy. I tried to get out and lay down but I fell out of the shower instead. I couldn’t tell anyone what was wrong because I couldn’t form any thoughts or words.

…head rush, as if I stood up to fast. No pain.

My left cheek had started to feel funny. It felt like when you went to the dentist and got Novocain and starts to wear off… an irritating numbness.

I was sitting down to tie my shoe and all of a sudden, my left hand wasn’t cooperating. It was banging against my shoe…I called for my husband but my words didn’t come out right. I tried to walk to him but collapsed on the floor…I didn’t feel any pain and definitely didn’t notice any symptoms prior.

I had trouble walking down the stairs…two days later, I became extremely confused and disoriented.

I got up to use the restroom. When I got back into bed, I couldn’t lift my right leg. I tried to wake my husband, but I couldn’t speak, so I shook him instead.

To paralyzing pain:

…The headache was extremely severe, almost paralyzing. Whatever song was playing on the television got trapped on repeat extremely loudly in my head…

I felt a pain that I will not soon forget strike through my right eye and up through my skull. It felt like a white hot bolt of lightning electrocuting my brain. The horizon was bouncing when I looked across the way. Worst migraine I’ve ever had for five days straight.

I had a headache that would not quit. I had worked all day and was going to a family wake. My headache was severe and my spouse looked at me and said I was going to the hospital.

I felt a sharp pain behind my left ear followed by an intense migraine headache with dizziness, falling, nausea and vomiting.

The Lead Up to Stroke: Early Unrecognized Symptoms

If birth control hyper-activates blood clotting, surely as clots progress in size and number, especially if they are in the brain, there would be symptoms? Indeed, there are. As women, however we tend to ignore our own health, and unfortunately, so too do our physicians. So even when the pain reaches an unbearable state, and we seek medical attention, it is often dismissed.

“I may have been having transient ischemic attacks for about six months prior to my stroke…I had been having episodes of dizziness and headaches leading up to my stroke. Since my stroke I have not had any of these episodes.”

One of my legs was swollen for a month before the stroke. My stroke started in the morning while I was at work. I have chronic migraines, and at first, I thought it was migraine. After work, I went home and rested. The symptoms kept getting worse, and when I tried to get up, I couldn’t walk.

The headache started a month earlier…I also had unexplainable pain in my left thigh.

Headache responded to Tylenol for five days. Wasn’t thinking it was a stroke. Vision blurry in one eye for a few days – assumed contacts needed changing or a new eye exam. Not until speech became impaired did we jump into action and rush her to the ER.

I had a burning and throbbing sensation in my head. It was not a headache. The sensation was felt from ear to ear, around the back of my head, across the center of the back of my head. I also felt the sensation on the right side of my head, close to my ear. I felt it for about a week in January (four months prior to the stroke), then it went away. The blurry vision started at the end of February (two months prior), and by March (one month prior), the burning and throbbing was constant – all day, every day.

Electrical shock sensation down my arm. Immediate dizzy spell…Tried to get dressed and my left hand didn’t understand that I was trying to grab my jeans of the bed. I went to work. Didn’t know that I had a stroke…I wasn’t diagnosed with a stroke for six months following. They assumed I had MS. The lesion on my brain looked like MS…

Clotting Disorders and Birth Control

One of the more striking patterns that we saw across all types of clot events, was the lack of recognition that hormonal birth control is contraindicated in women who have clotting disorders. None of the women in our study were tested for clotting disorders before being prescribed the contraceptive, even when there was a family history of clotting.

“I told my gynecologist that my father had had blood clots. She said, ‘That’s not a problem. The pill is only contraindicated if YOU had a blood clot.’”

Clotting disorders, it appears, are only ever recognized after one has a clot. For some women, this medical misinterpretation is deadly.

Missing the Clot

Over and over again, we saw symptoms dismissed or misdiagnosed. With impending stroke, the pain is often attributed to migraine, but as was indicated above, the pain was far and above that of a migraine.

The gynecologist told me the pain in my leg was probably just a muscle strain and she prescribed Imitrex for the headache…The migraine medication made the headache go from dull and persistent to unbearable…Over the next two days, I would take three ambulance rides, be sent home from the emergency room twice, begin to lose control of my body, and be given a very stern lecture from a nurse who thought I needed to learn how to ‘manage my stress’.

Since the medical staff at the ER originally thought it was a bad migraine, I received narcotics and Novocain shots in the back of my neck and the base of my skull to numb the muscles.

What Have We Learned?

The more stories we review, the more clearly we recognize that as women we don’t trust our intuition that something is wrong. This is often because our concerns have been dismissed by doctors in the past, or we fear that they will be. Except for perhaps those crises that happened suddenly, there were warning signs, sometimes seemingly innocuous warnings, but warnings nevertheless. Inevitably those warnings were put aside. As women, we are taught to be tough and plow through our health issues. We go to work, take care of our kids, our families, even when in excruciating pain. I think it’s time we learn to take care of ourselves first. If something doesn’t feel right, we need to trust our instincts, and be persistent in advocating for our own health.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter. 

This article was published originally on October 5, 2016. We subsequently lost funding to finish this study. Nevertheless, we are still accepting stories about birth induced blood clots. If you’d like to share your story, send us a note: Write for us. Other stories and articles about birth control and blood clots can be read here.   

Image created in Canva with AI; property of Hormones Matter.

Birth Control Induced Pulmonary Embolism While Driving

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I am a 37 year old woman who has been taking birth control since I was 15 years old and I had a pulmonary embolism (PE) while driving last year. I was on Aviane for over 6 years and then switched to Camrese on 9/19/18 and was taking that up until the PE on 12/13/2018. Before going Aviane, I was on many other generic forms of estrogen type birth control since I was 15 years old. My main reason for taking birth control was to control my cycle. Preventing pregnancy came later on in my adult life.

On December 13th, 2018, I was traveling home from a Tribal Belly Dance Retreat in Hawaii. I was in the best shape of my life and was really enjoying my life to the fullest. While driving from the Phoenix Airport to Flagstaff Arizona, I started to feel tired. I felt like I was going to pass out. The anxiety of that feeling was intense. Within an hour after I started driving, I lost consciousness on Interstate 17 going northbound and then I came to, going 75mph. I lost control of my car and flipped 4 times, continuing to gain and lose consciousness, until the car stopped. I had no idea I was having a pulmonary embolism, until I reached the hospital and they saw something odd in my MRI.

During the crash, I was terrified. I really thought I had gone to hell. After the car stopped rolling, I was alone and could not figure out how to get out of the car. I passed out in fear and then woke up outside of my car, wandering around. At some point, I picked up four tarot cards from the mess of the paperwork and luggage that was thrown from the trunk of my car. I was completely alone in the middle of highway. Luckily my car rolled into a patch of rocks and grass, instead of the area I had just passed, which would have left me in a ditch of one of the multiple cliffs along Interstate 17.

The next thing I know, a truck driver came from out of nowhere and called 911 to get me help. I have not been able to get in touch with that truck driver who saved my life or the ambulance EMT that rode from Sedona to Flagstaff with me and kept my spirits up during the most confusing and scary time of my life. I would really like to thank them for their kindness.

At the hospital, they identified the pulmonary embolism through an MRI. I was shocked and freaked out, to say the least. That night at the hospital, I went into convulsions and had a mini-seizure, which lasted about half a minute. After four days, they released me from the hospital. It was noted that I would be on blood thinners for 6 months. I was not able to return to work until January 21st and only then with a limited work schedule of only 4 hours a day. I just recently returned to work on a normal schedule on February 12th.

This has event has left me with a totaled car, monstrous hospital bills and limited funds to pay for it all due to how long I was out of work. I am also at a loss for words that the mental stress it has caused. I will never be the same but I am thankful that I am alive.

Prior to the pulmonary embolism, I was a casual social smoker, smoking only 1-2 cigarettes every 2 weeks. I have since stopped completely. I was generally healthy but had one issue that my naturopath said was related to the birth control. I developed chronic salivary gland stones and had about 5 of them removed in 2014. My body has produced them since 2005 and all of the doctors I have seen, have never been able to tell me why, except my naturopath, Dr. Brandi Gowey. She said at one point that she thought they were a result of the birth control I was taking and had recommended that I come off the birth control. I obviously did not take that advice. I wish I had.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

Pulmonary Embolism after Four Months on the Pill

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I was a sophomore in college when my life changed. I was an active college student who enjoyed going to the gym. One night I was at the gym on the stair climber and something did not feel right. I got off and all of a sudden blacked out. My heart was racing, my chest was tight and I was very scared. I went back to my dorm to try to sleep it off, but I had a hard time falling asleep.

The next morning I tried walking to class, but once I stepped outside I could not breathe. Going to school at the University of Nevada, Reno it was snowing and cold, so I thought I couldn’t breathe because of the chill. Shortly after, I called my mom and she insisted I go to the campus health center. I went and they did a bunch of tests. Finally, the doctors decided to do a blood test. If those results came back positive, I would have to be rushed to the ER.

Sure enough, I had a positive result. I had multiple pulmonary embolisms. I was hospitalized for three days and given many different anticoagulants (blood thinners) to get my levels back to normal.

After this happened, I was scared for a very long time. It took me a while before I could get back on the stair climber at the gym due to the event. Luckily, I am all healthy now. I take a baby aspirin in the morning to prevent any clotting. I am lucky to be alive and I am very thankful for that.

Symptoms Leading up to the Pulmonary Embolism

Looking back, I had some chest pain during the week, but I figured my symptoms were from the cold I had. It was not until I was on the stair climber, working out vigorously and passed out that I thought something was wrong.

Prior to that, I was not taking any other medications, just the birth control. The pill I was on is called Trivora. I was in overall good health.

I started birth control in August of 2013 and I had my PE on December 2, 2013. I was only the pill for 4 months. I took it religiously, every day at the same, for the four months I was on it.

After I was hospitalized, I had to go to a Coumadin clinic to test my blood every week. I also had to see a cardiologist and get an echocardiogram to make sure that my heart was okay with all the Coumadin that I was taking. Luckily, everything came back negative.

The doctors did test me for clotting factors and heredity tests to see if it ran in my family. I was the only woman on birth control in my family. Luckily, those tests came back negative too.

To this day, I continue to work out regularly and listen to my body if I feel something is not right. The biggest aspect that saved my life was going to the doctor. I know many people are afraid of doctors or worried that they will hear bad news, but it can save your life. I tell all my friends who are on birth control that if they feel not right or something is off with their body to seek medical attention right away.

I hope what I experienced never happens to anyone else. It was the scariest experience of my life and I count my lucky stars every day to be alive.

Real Risk Study: Birth Control and Blood Clots

Lucine Health Sciences and Hormones Matter are conducting research to investigate the relationship between hormonal birth control and blood clots. If you or a loved one have suffered from a blood clot while using hormonal birth control, please consider participating. We are also looking for participants who have been using hormonal birth control for at least one year and have NOT had a blood clot, as well as women who have NEVER used hormonal birth control. For more information or to participate, click here.

Julia’s Story: NuvaRing Induced Disseminated Intravascular Coagulation

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Julia Ruth West Ross (1983-2013)

Julia, our middle daughter, lived in Southern California while earning an M.A. in Economics at UC Irvine. She enjoyed Southern California because there was so much she liked to do there.  She loved camping, beach trips, Mexican food, music concerts, hanging out with friends, beer tasting, and her two cats.  She started working at her first professional job in 2011 and she then met her husband Eric. Julia and Eric had just married and were so excited to be in their new apartment and all of us were so happy for them. It was a wonderful time.

Julia called me on Tuesday night on her way home from work. She was looking forward to the upcoming weekend as she was getting things packed for their delayed honeymoon cruise that coming Sunday. She was so happy.

Eric and Julia were married for just under five weeks when I got a call two days later from Eric that Julia was in the Emergency Room.

Early Signs of NuvaRing Clotting

Eric told me that Julia had been feeling tired for a few days, but that on Wednesday night, as she walked to her car after work, she felt faint, had tunnel vision and was short of breath. She got home and climbed into bed early. Usually full of energy, this was not like Julia, and Eric was surprised when he came home from work to find the house dark and Julia in bed. She told him she felt really tired and nauseous. He later told us that night “she threw up once or twice but it was mostly just dry heaving with just a little bit of liquid, the liquid though was very dark. Also, she had not eaten very much the last few days. I don’t remember the exact details but I think she had hardly eaten the day before and may not have really eaten that day either. If she did eat, it was a very small amount.” She also had diarrhea.

Thursday morning, thinking she had the flu; Julia stayed home from work, another unusual thing for her. Later that morning she called Eric, asking him to take her to an Urgent Care. She was feeling worse. She couldn’t breathe, felt very weak and faint. Eric rushed home and took her to Urgent Care.

At Urgent Care they saw she was in respiratory distress. Her blood pressure was low and her heart was racing. As they were preparing to intubate her, she fainted. They completed the procedure and transported her to the Emergency Room. We read later in her medical records that she told them she felt “a sense of impending doom,” and we also read that the ER doctor removed a NuvaRing.

Eric called again much later that Thursday night to tell us the doctors wanted to put Julia in the ICU and asked him if her parents knew. He also told us that the doctor said her kidneys weren’t functioning and they wanted to put her on dialysis. This was more than a standard emergency room visit. The ICU? Kidneys not functioning? Dialysis? Do her parents know? We didn’t know what to think. Alarmed, worried, and not understanding what was happening, my husband and I flew the 450 miles to be with Julia.

We arrived at the hospital on Friday morning, and saw Julia briefly. She was sedated, so she didn’t know we were there. The nurse sent us to the waiting room because she needed to do some things in the room. Waiting seemed to take forever.

Sepsis or Missed Pulmonary Emboli?

An hour later the ICU doctor came to tell us that they thought Julia had septic shock and they had put her on a sepsis protocol, giving her antibiotics and antifungals to treat any infection. They also had her on vasopressors to help increase her blood pressure. They were also trying to get a dialysis machine set up.

The ICU doctor assured us that Julia would recover, saying, “Julia is young and strong.” The doctor seemed very confident as she explained that Julia would be in the ICU for a few days and moved to another floor to recover for a week or more. The doctor sounded so sure of herself.  We were still anxious and just wanted to be with our daughter. Her dad and I again were allowed to see Julia briefly although we were told again that we needed to wait in the waiting room as they were setting up equipment. We waited with Eric, his parents and sister. We cancelled the cruise trip, thinking it was just a postponement until Julia got better.

An hour later, a nurse ran into the waiting room, yelling, “West family, we need you NOW!” and rushed us down the hall to Julia’s room. The ICU team was frantically doing CPR on Julia. Shocked, we huddled together in the doorway, clutching each other, as we watched the medical team frantically work on Julia.

The ICU team stabilized Julia and we all breathed a sigh of relief and moved out into the hall. Calm was restored to the room and the staff began drifting off to other tasks. Julia went into cardiac arrest again. Again we watched the team rush to perform CPR. We stood outside a set of large sliding glass doors to Julia’s room, with disbelief and increasing dread until Julia’s heart was again stabilized. Calm lasted for what seemed like minutes. Again and again Julia went into cardiac arrest, one after another for over four hours. The ICU team kept up their heroic lifesaving efforts to resuscitate and stabilize her.

One of the doctors on the team told us that we’d have to make a decision at the end of the next hour as to whether to continue resuscitation. We’d been in the hallway for hours and we were told that Julia’s chance of being severely brain damaged was 95% because her blood was so very thin and she’d had so little oxygen to her brain. At the end of that last hour, we reluctantly and painfully told them to stop. We felt we had no option but to let her go. We believe Julia wouldn’t have wanted to live a diminished life, even if they could have saved her. The staff stopped their efforts and left the room for us to gather around Julia’s bed. Within ten minutes of stopping CPR, she was gone.

Asking Why

We left the hospital profoundly shattered and in shock. We had been told that she had septic shock, but we couldn’t understand how that led to her death. We wanted to know what had happened to our wonderful daughter. We requested an autopsy, as did the hospital. We also ordered Julia’s hospital records.

Later, my husband and I flew home. Julia’s husband, her sisters and brother were as devastated as we were.

The autopsy report stated that Julia died from massive bilateral pulmonary embolisms. The autopsy also showed she had a deep vein thrombosis (DVT) in her left leg. The blood clots in her lungs were so massive that no amount of resuscitation could have brought her back due to the massive clots blocking her lungs.

None of this made sense to us. Only the month previous, Julia had a health check up through her employer that showed she was healthy. Her blood pressure was normal, as was her cholesterol.

We wanted to know why our daughter developed pulmonary embolisms and a DVT.  We discovered Julia was using the NuvaRing. We didn’t even know what a NuvaRing was. Our youngest daughter told us that she’d heard of women getting blood clots while on NuvaRing, so we began reading about the increased risk of blood clots for women on estrogen based birth control.

The ICU doctor told us that Julia had septic shock. We knew nothing about sepsis or septic shock. We wanted answers to everything, so we contacted the ICU doctor who had treated Julia and began asking questions, lots of them.

NuvaRing Induced Disseminated Intravascular Coagulation

We learned that Julia had been treated for a condition called Disseminated Intravascular Coagulation (DIC), a process characterized by the widespread activation of the blood-clotting cascade. We had to educate ourselves about DIC and found that DIC is caused by an underlying condition. The increased clotting in DIC uses up platelets and clotting factors in the blood. DIC can cause very small clots to form throughout the body’s small blood vessels. These small blood clots can reduce or block blood flow through the blood vessels, which can damage the body’s organs.  When platelets are used up, the body isn’t able to stop bleeding, as the blood is thin due to lack of platelets. Had tiny clots formed in the small blood vessels in Julia’s body? Was this why Julia’s kidneys stopped working efficiently?

In reviewing the hospital records, we noticed that the hospital had done a CT scan of her abdomen, but they only did x-rays of her chest. We learned that clots do not show up on x-ray. A chest x-ray can find other diseases, such as pneumonia or fluid in the lungs but not blood clots.

The hospital had not done an ultrasound on Julia’s legs to look for a DVT, but leg pain or soreness was not one of Julia’s symptoms. We also looked for lab results for infection that might have caused sepsis or septic shock, but the lab records didn’t show any positive results for anything they tested for.

Julia had not complained of all the typical symptoms that you read about for a DVT or a pulmonary embolism.  We learned that many people do not have the classic symptoms.

At that first phone call with the ICU doctor, after she reviewed the autopsy report, she told us they had not known Julia had pulmonary embolisms when she went into cardiac arrest.

NuvaRing and Julia’s Death

We asked the ICU doctor if the NuvaRing had anything to do with the pulmonary embolism. This doctor, who worked so hard to save Julia, was not familiar with the NuvaRing birth control and suggested we go to the company website for information. Her suggestion made me realize that she really didn’t know much at all about the NuvaRing. She told us that none of the lab tests had shown a cause for the sepsis. She also told us that the hospital would do a formal review of Julia’s case with a team of doctors, including those who had worked on Julia. The doctor couldn’t say more until after the formal review.

The hospital team eventually reviewed everything that happened to Julia, from her admission, treatment, and to her death. We spoke to the ICU doctor again after the review, and she told us she “did a lot of reading, a lot of research on the NuvaRing and strongly felt it had been a component in Julia developing such a massive pulmonary embolism.” She also explained that “a pulmonary embolism might have been brewing,” but that because Julia’s blood developed DIC her blood had become so thin that trying to surgically treat a pulmonary embolism would have caused her to bleed to death, and they couldn’t even give her anticoagulation treatment for the clot.

More importantly as to the cause of death, the ICU doctor told us,

We do not see someone as young and healthy as Julia develop such massive pulmonary embolisms unless there is an underlying factor… and that is hormonal birth control.

The ICU doctor said she and other doctors on the team,

Personally believe the NuvaRing caused Julia’s blood to clot and develop DIC as quickly and as much as it did.

This doctor went on to say:

In young patients like her, any time we see someone pass away from a massive PE like she did, it has never been just from an infection, never been just from sepsis.

It’s always been because of some underlying pathology that has caused the blood to clot the way that it does. Usually it’s an oral contraceptive pill, that’s 90% of the time, and 10% of the time it’s because there’s a genetic predisposition that went undetected or no one in the family had had that problem before. And we didn’t find out until much later.

Julia had been using NuvaRing for two years.

We believe the hospital staff did everything they knew how to do at the time. We truly thank them for all their efforts. But we also believe that they did not connect the dots about a pulmonary embolism forming or that hormonal birth control was causing the clotting that led to Julia’s death.

Our family will never be the same. Julia, our cherished daughter, sister and wife, was young, healthy, loving, vibrant and bright. She had a whole lifetime ahead of her. Julia had confidently used NuvaRing, a combination hormonal birth control, because it had been prescribed confidently to her. We share Julia’s story with our deepest hope that this won’t ever happen to any woman you love.

Dru and Joe West

Laura West, Marc Fish, Nancy Martin and Eric Ross

Photo: Julia pictured with her dad on the day of her wedding. 

Real Risk Study: Birth Control and Blood Clots

Lucine Health Sciences and Hormones Matter are conducting research to investigate the relationship between hormonal birth control and blood clots. If you or a loved one have suffered from a blood clot while using hormonal birth control, please consider participating. We are also looking for participants who have been using hormonal birth control for at least one year and have NOT had a blood clot, as well as women who have NEVER used hormonal birth control. For more information or to participate, click here.

TIA Provoked by Birth Control Pills Prescribed for Endometriosis

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I’m a 34 year old woman living in North Italy. I’ve had pelvic pain since my first period, which several doctors have stated is likely due to endometriosis. In trying to treat this pelvic pain, I was prescribed the birth control pill, which led to me having a transient ischemic attack (TIA).

Seeking Help for Endometriosis

In January 2012 I suffered from a strong pain around my left ovary and I decided to consult with a gynecologist. After a negative transvaginal ultrasound the doctor just prescribed some over-the-counter painkillers, telling me not to worry about my pain. I asked if it could be endometriosis (I had read an article about it and realized it explained all my pains) but he minimized it and told me again not to worry about it.

At first I felt reassured, but my pain was always there: pelvic pain, bowel pain, backache, and fatigue. In June 2014 I consulted with a gynecologist at a hospital in North Italy where there is a specialized centre for endometriosis. After a negative abdominal ultrasound they ordered a pelvic MRI, and suggested progestogenic therapy with Primolut Nor (Norethisterone Acetate).

The MRI was negative and since the hospital was far away from home and I wasn’t happy with the doctor I met, I decided to consult with another gynecologist in my town. In April 2015 the new doctor prescribed me a blood test: blood count, white blood cells, serum iron, folic acid, thyroid hormones, prolactin and CA125 (only the last two resulted slightly high). Then she prescribed me Primolut Nor, ¼ pill every day.

I asked her about possible side effects but she told me not to worry since the dosage was low. I started taking the progestin pill on June 9. After a few days I felt a strange feeling in my body, quite difficult to describe, but I felt like something wrong was going wrong inside me. My breasts were very sensitive, almost painful. My hair became thinner and started falling out especially around my ears. This stopped only after 6 months, during which a dermatologist prescribed me supplements and other hair products; psychologically it was a very difficult time.

Transient Ischemic Attack

On the fifth day, I suffered from a migraine with aura. Some days later I lost sensitivity in the 5th finger of my right foot; I had never experienced anything like that before, but I didn’t pay much attention to it. On June 25 my period started. In the evening I felt something like a pressure, a weight on my chest and some difficulty in breathing. I also had a strong headache, different from any one I had before.

The day after, in the morning, I started feeling strange, cold, weak and shivers in my body. Then suddenly I felt a sharp pain behind my right ear and I lost sensitivity in the right part of my face and in the right arm. I was very scared.

I phoned my gynecologist but she was busy. I called my family doctor and he told me to take aspirin during that day and stop taking Primolut Nor. After some hours the sensitivity slowly came back, but it took some days to feel normal again.

Thinking about it later I think I was very lucky and I should have gone to the hospital immediately but I didn’t understand the seriousness of the situation at that time. In the evening my gynecologist phoned me back, telling me to make an appointment to meet her.

We talked about what happened, and she told me I suffered from a transient ischemic attack, which is just like a stroke, where a blood clot blocks a blood vessel in the brain, except with a TIA that the blockage is temporary and goes away on its own. A TIA serves as a warning sign that a stroke is going to happen. My doctor thought that it was very strange because the dosage of the pill was so low, and that maybe it wasn’t the pill’s fault and that it could have happened even without the pill (this explanation really dissatisfied me). She said she couldn’t do anything more for me and suggested me to consult with a hospital in a nearby town, which deals with endometriosis.

Still Suffering with Endometriosis

In the meantime, my pain had become unbearable and present almost every day. I had also developed digestive difficulties. In August 2015 I met another new gynecologist. She did a transvaginal ultrasound which showed an irregularity in the uterus, probably adenomyosis, and another irregularity behind the uterus, probably an adherence with the bowel. But she explained to me that there’s no way to operate and cure the uterus of adenomyosis, except to do a hysterectomy. Because of my symptoms, she thinks I also suffer from endometriosis (like the other doctors said to me before).

She said it was too dangerous to try the pill again. She sent me for some tests, which I did during the past months: a new CA125 blood test, a pap test, a lower gastrointestinal series and a consult with a gastroenterologist (who prescribed me stool tests and celiac disease tests). She also sent me for a pelvic ultrasound, but despite the sharp pain I felt in some specific areas of my pelvis, it didn’t show anything. All these exams were negative.

Since last fall I’ve also started suffering from pain in my hips. The X-rays didn’t show anything and so my family doctor sent me for a MRI. While the hips looked normal on the MRI, it unexpectedly showed what seems an endometrioma cyst on my left ovary. I know it sounds strange to say, but this discovery has given me new hope. It finally shows that all the pain isn’t in my head (I never thought it was, but this is how I’ve often felt dealing with other people about my illness); and now that I’ve completed all the tests and I have to go back to the gynecologist, maybe this time some treatment could be discussed (maybe a laparoscopy?) and I will gain some relief. All aspects of my life are of course influenced by my health condition, but I don’t want to give up, even if year after year, exam after exam, I sometimes feel very stressed and weary.

Real Risk Study: Birth Control and Blood Clots

Lucine Health Sciences and Hormones Matter are conducting research to investigate the relationship between hormonal birth control and blood clots. If you or a loved one have suffered from a blood clot while using hormonal birth control, please consider participating. We are also looking for participants who have been using hormonal birth control for at least one year and have NOT had a blood clot, as well as women who have NEVER used hormonal birth control. For more information or to participate, click here.

Blood Clots: What Women Know Versus What We Should Know

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I was on the birth control pill for ten years. I knew that it could cause blood clots in women over 35 who smoked. I wasn’t over 35 and I didn’t smoke. That was all I thought I needed to know. Then I had a stroke. It was caused by the pill and a genetic clotting disorder I never knew I had. In fact, I didn’t know there was such a thing as clotting disorders or that I could have one or that in combination with hormonal birth control, it could kill me. And I certainly had no idea what the symptoms of a blood clot were.

What Do We Know? Not Too Much, It Appears

When I began to do research for my thesis, I wanted to know if it was just me or if other women who took the pill were also unaware of clotting disorders and of the symptoms of a blood clot. Spoiler: I wasn’t alone in my ignorance.

I surveyed over 300 women who had taken birth control pills. Among other things, I wanted to know:

  • What did women know about the risks associated with the pill?
  • Were they aware of clotting disorders?
  • Did they know the symptoms of a blood clot?

Survey Results

Neither Women Nor Their Doctors Understand Risks for Blood Clots

The results of the survey showed that women do not clearly understand the risks involved with taking birth control pills. Many of them believe that certain risks are only associated with being over 35 years of age and/or smoking. This is not surprising given that only a little over half said their doctor discussed the risks with them before giving them a prescription. And for a majority of the women, their doctor never discussed other birth control options with them.

Most of the women were asked about their family history before being given a prescription, but fewer than half of their doctors actually discussed it with them, and fewer than a third of the women actually read the risk information that accompanies their prescriptions. That’s not surprising given how dense and misleading the pharmaceutical companies have made risk communication.

When asked whether they were familiar with the symptoms of a blood clot, most women (60.5%) admitted that they were not. Eight women responded that they had learned the symptoms because a family member or friend had a blood clot, and two participants said they had actually had blood clots. One stated, “When I experienced chest pain and did research online. It turned out that I had pulmonary embolisms (while on BCP- birth control pills).” Only 6 out of 311 women reported learning about the symptoms of blood clots from their doctor. Ironically, more women knew someone who had a clot.

At the end of the survey, the participants were invited to share anything further about their experience on the pill. Here are some of their answers:

My experience on birth control pills, the Nuvaring, or Depo-Provera all proved to be horrendous… I think birth control pills came straight from hell and I hate, hate, hate it. I would rather undergo Chinese water torture daily thank take birth control, and that is the God’s honest truth… My fertility has been affected forever by my under informed choice to go on birth control, and by the irresponsible doctors who encouraged me to switch methods rapidly “until I found what worked for me.”

 

I’ve had two different GYNs give me completely contradictory information about the side effects and dangers of BCPs… Overall, I’m surprised at how little doctors seem to know about female BCP- I haven’t experienced this amount of ambiguity with any other medical specialty or problem.

 

I was shocked- and grateful- when I finally found a doctor who discussed alternatives with me, suggested a wide variety of reading, and let me do my own research and make my own decision before wiring[sic] a prescription. After doing the reading, there is no way I will ever take another birth control pill in my life. Every other doctor I had acted like it was giving out Altoids…

 

I think they’re too often the first option doctors prescribe for reasons other than birth control. That’s frustrating. They’re not a magic pill and some doctors seem to think they are.

The bottom line is that most women do not fully understand the risks involved with taking birth control pills and they are not familiar with the symptoms of a blood clot.

At my thesis defense, when I mentioned that most women (over 60%) did not know the symptoms of a blood clot, my advisor asked, “Well, I don’t think that’s so unusual. Do you think most people know what the symptoms of a blood clot are?”

“No, but I think people who have been prescribed a medication that greatly increases their risk of blood clots should be informed of the symptoms,” I responded.

Who Is Responsible?

This is a simple question with a complicated answer. Who is responsible for making sure women who use hormonal contraceptives, especially women who are at a much higher risk for blood clots, understand the symptoms and when to get help? Is it the responsibility of the doctor who prescribed the medication? Or is it the responsibility of the pharmaceutical company to provide clearer information? Or is it the responsibility of the patient?

From my personal experience, I now know that I cannot trust my doctor to always make the right diagnosis and provide the right treatment. Most of their information comes from the pharmaceutical industry who have clearly demonstrated that they put profit first. And our research is showing that their information is not correct. Therefore, I cannot rely on the drug companies to make sure they provide me with accurate and straightforward information about their medications.

So that leaves me. And you. Until we demand a system that puts patients first, a system of health and transparency, we have to put ourselves firsts. How? We do that by listening to our bodies, doing the research, and learning to trust our intuition. That may mean we have to disagree with our doctors. That may mean we have to ask for a second opinion. That may mean we have to insist on being heard. We can’t be afraid of offending someone or “rocking the boat.” We can’t be afraid of being considered hysterical or melodramatic. We can no longer sit back and hope others are making the best decisions for us. We have to educate ourselves. We must be our own advocates. Our lives depend on it.

And we can start by learning the symptoms of a blood clot.

What Are the Symptoms of Blood Clots?

 Blood clot in leg:

  • swelling
  • pain
  • tenderness
  • an unusually warm sensation in the affected area
  • an unusually cold sensation in the affected area (this is per our research, more details to follow)
  • pain in your calf when you stretch your toes upward
  • a pale or bluish discoloration

Blood clot in chest:

  • sudden shortness of breath that can’t be explained by exercise
  • chest pain, may feel like extreme heart burn
  • palpitations, or rapid heart rate
  • breathing problems
  • coughing up blood
  • dizziness (per our research)
  • uncharacteristic fatigue (per our research)

Blood clot in the brain:

  • severe headache
  • loss of speech
  • numbness or tingling of limbs
  • difficulty seeing or changes in vision
  • difficulty speaking or finding words

For more information about blood clots, especially in conjunction with hormonal contraceptive use, click here.

Pulmonary Embolism after 10 Years on the Pill

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I’m a 27 year old woman who was diagnosed on March 18, 2016 with blood clots in both lungs and a pleural effusion in my left lung. I’ve always been pretty active, and enjoy running, hiking, HIIT, spin, and yoga, among many other activities. I have never had any major health issues or been hospitalized. I’ve never even broken a bone before, so having a problem this serious came as quite a shock to me.

I’ve been taking oral contraceptive pills since I was 16. I started with Tri-Cyclen Lo, and was on that up until a couple of years ago when I switched to Alesse. Most recently, I switched to Alesse’s generic brand, Alysena 21, in order to save money on my prescriptions and had been on those pills for about a year before my pulmonary embolism.

I had been experiencing some pain in my back/chest for a couple of days prior to my diagnosis, which got worse when I lay down. I thought I just was experiencing really bad heartburn, as I had previously seen my doctor complaining of heartburn and she prescribed some stronger medication. The fact that the pain wasn’t going away even after trying to take the medication made me a bit concerned.

On the second night when I tried to sleep, I had severe pain in my upper back and left side of my chest, which started to radiate up to my neck and left shoulder. I also experienced more pain in my chest if I tried to inhale deeply. It almost felt like I just needed to breathe deeper and I would get relief, except it never came. The only way I could possibly lie down was on my stomach with my left arm hanging off the bed, and even then it hurt a lot. My fiancé suggested that it might just be a pulled muscle, but I finally decided that something wasn’t right so I went to emergency.

Once I got to the hospital, I explained my pain and then had an EKG, chest X-ray and blood work done. My D-dimer blood test showed that I had a high risk of blood clots, and my X-ray showed fluid in my left lung. They then scheduled me for a CT Scan, which I had to wait many hours for. I was given a Percocet to help ease the pain and I tried to lay down while I waited for the CT Scan. After getting the scan done, the doctor told me that I had blood clots in both my lungs and a pleural effusion in my left lung.

I was shocked and didn’t really know how to process the information. My mom, who is a nurse, was with me and she seemed worried as well. After speaking to a bunch of different doctors, and waiting around to see a few specialists, I was finally given a prescription for Xarelto, an anticoagulant, and sent home to rest.

The days and weeks following were pretty difficult. I felt useless, and for the first few days it was a struggle to even walk around my neighborhood. I had extreme shortness of breath, and walking around made it a lot worse. It also still hurt to lie down for the first few days, so I was pretty uncomfortable and tired.

I had follow-up appointments with my family doctor, and was scheduled for more chest X-rays to monitor the fluid in my lung. Eventually the fluid went away after a few weeks, and I was slowly starting to feel like myself again. After about a month or so, I started trying to exercise again – starting slowly at first. I’m now almost back at the point where I was prior to the pulmonary embolism, and even managed a seven kilometer run this past weekend. I’m still on Xarelto, and will be for a minimum of 6 months. Once I stop taking that, I can be tested for blood clotting disorders, including Factor V Leiden.

For the past couple years I had been wanting to stop taking birth control, as it was an inconvenience to take a pill every day at the same time, and it just didn’t seem healthy or natural. However I never ended up going through with it, as I felt like I needed to be on them in order to avoid pregnancy. Now that I’ve stopped taking them because of my pulmonary embolism, I feel healthier and will never take hormonal birth control pills ever again. There are better options for birth control out there that don’t involve hormones and are much safer for your well-being. A few of my friends have actually decided to stop taking birth control pills after this happened to me. I hope to get the word out to other women about how potentially dangerous and unnecessary birth control pills are.

Real Risk Study: Birth Control and Blood Clots

Lucine Health Sciences and Hormones Matter are conducting research to investigate the relationship between hormonal birth control and blood clots. If you or a loved one have suffered from a blood clot while using hormonal birth control, please consider participating. We are also looking for participants who have been using hormonal birth control for at least one year and have NOT had a blood clot, as well as women who have NEVER used hormonal birth control. For more information or to participate, click here.

Why Am I Here? Thoughts on Survivor’s Guilt

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“I’m so glad to see you. I didn’t think you were going to make it.”

If you’ve read my story, you may remember that is what the emergency room doctor said to me a few weeks after I had a stroke. I had only been out of the hospital for a week when I developed a rash from the seizure medication I was taking. Because it was a Friday night, my neurologist told me I needed to go to the emergency room. I cried as my in-laws drove into the parking lot of the little local hospital. It was the very same hospital that had sent me home twice before finally discovering, days later, that I had blood clots and was bleeding into my brain.

“You’re a miracle.”

One of the advantages of having a stroke at 28 is that when you return to the ER, they finally take you seriously. I was ushered into an examination room within 5 minutes of checking in. As I waited to be seen by the doctor, a nurse came in. She was very excited and a little emotional.

“Hi,” she said. “Don’t you remember me?” I did not. “I sat with you for hours when you were in here a few weeks ago.”

I immediately began to feel very guilty for not remembering this lovely woman who so obviously cared about me. She took my hand in hers. “You’re a miracle,” she said reverently.

Confused about what the appropriate response to that was, I smiled meekly and said, “Thank you?” When she left the room, I could hear her talking to people up and down the hall. “The miracle girl is here!” she said over and over.

Later, I would lay in bed, or sit on the couch, or ride in the car and wonder, “If I’m such a miracle, why am I here?” What was an enthusiastic and loving sentiment from that nurse turned into a real mindf*@k (pardon the language but there was really no phrase that worked as appropriately here) as my poor, broken brain puzzled over why I had survived.

What is Survivor’s Guilt?

Trying to understand your purpose in this world is a tough enough task. Nevermind trying do it while you’re struggling to just tie your shoes and feed yourself. I wanted to put it out of my mind and just take things one day at a time. But it was hard to do that. There is so much uncertainty during and after a health crisis like a stroke. What will my life look like now? Will it ever look like my life before? Do I want it to look like my old life? Of what kind of life am I even capable?

At the time, I wouldn’t have called it survivor’s guilt, but that may have been what I was dealing with. Survivor guilt (or survivor’s guilt; also called survivor syndrome or survivor’s syndrome) is a mental condition that occurs when a person perceives themselves to have done wrong by surviving a traumatic event when others did not.

Though more common, or perhaps more noted, in survivors of combat and natural disasters, it can also occur in patients who have overcome a health crisis (cancer survivors, HIV/AIDs patients, etc.). It was originally identified in the 1960s in survivors of the Holocaust and since been re-categorized as a symptom of Posttraumatic Stress Disorder.

Treating the Whole Patient

Because we don’t usually think of health crises as causing PTSD, the guilt and other mental health conditions that accompany these situations are often left untreated. I was treated for my stroke physically, but not really mentally, except in the capacity that it affected my actual cognitive abilities. I was sent home from the hospital with prescriptions for blood thinners, seizure medication, and a whole host of other drugs to counteract the side effect of the other two (despite the fact that I had not exhibited any of those side effects). Yet no one asked how I was dealing with the emotional side of what happened to me.

And it’s not just stroke survivors that have trouble processing what happened to them.

Depression is 3 times more common in patients after a heart attack than in the general population, with 15% to 20% of heart attack victims qualifying for a diagnosis of major depressive disorder, and a far greater proportion experiencing increased levels of depressive symptoms.”

According to the Lung Cancer Alliance, 63.9% of lung cancer survivors have experienced feelings of survivor guilt.

“While survivorship is often portrayed as an over-the-moon, happy feeling that all people battling cancer set as their goal, many lung cancer survivors feel burdened by it, experiencing emotions of guilt, anxiety and stress.”

Yet it seems that once the physical body is out of danger, many patients, myself included, are left on their own to unravel the emotional impact—to make sense of the new and unfamiliar life in which they find themselves. Often this process can take years.

For example, this project I’m working on is a staggering reminder that I have survived while so many haven’t. Though my stroke was 10 years ago, it is difficult to read the stories and interact with the families of the women who were killed by hormonal birth control. It brings me face to face with questions I thought I had long ago answered. Why me? Why did I live while so many others did not? And am I doing what I’m supposed to with this life?

I really needed you.”

About a year after my stroke, I told my dear friend Jamie about what the nurse said. I told her how much it weighed on me, about the pressure I was putting on myself. Her response was beautiful and simple and a good reminder for us all. “What if you’re here because I really needed you not to die?” Mind blown. Maybe some survivors are supposed to achieve great things and change the world. Or just maybe our purpose is as subtle and as profound as being there for someone else.

That message was enough for me for a long time. But when I was contacted about working on this project, I knew there was a reason. This work is important. Women need to understand the side effects of hormonal birth control, the symptoms of a blood clot, and that their options are not just the pill or pregnancy. We need to start asking why life-threatening blood clots, emotional issues, loss of libido, weight gain, as well as many other side effects are considered “acceptable.” We need to hold the pharmaceutical companies to a higher standard. We need to value human life above corporate profit. We need to take women seriously when they discuss their medical concerns. We need to fully research women’s health issues. The entire paradigm of women’s health care and contraception needs to change. The conversation has been started. And I think I may be here to add another voice to it. The voice of a survivor.

 

Real Risk Study: Birth Control and Blood Clots

Lucine Health Sciences and Hormones Matter are conducting research to investigate the relationship between hormonal birth control and blood clots. If you or a loved one have suffered from a blood clot while using hormonal birth control, please consider participating. We are also looking for participants who have been using hormonal birth control for at least one year and have NOT had a blood clot, as well as women who have NEVER used hormonal birth control. For more information or to participate, click here.