Thrombosis can be a side effect when taking estrogen and progesterone based contraceptive pills. With progesterone-only pills, the risk is significantly lower. So why do we not only use the latter? In an interview with Medonet, Prof. dr hab. n. med. Violetta Skrzypulec-Plinta – gynecologist, endocrinologist, sexologist.
- One of the known side effects of the pill is thrombosis. The risk that it will occur, however, is lower than in the case of childbirth or puerperium
- Giving up contraception because of thrombosis is not an option. Moreover, the problem does not apply to women who have been taking pills for at least three months
- In the first part of the interview, prof. Skrzypulec-Plinta explains the benefit-risk balance of using tablets. The gain is not only protection against unwanted pregnancy. You will read it HERE
- You can find more such stories on the TvoiLokony home page
Agnieszka Mazur-Puchała, Medonet: I’ve heard theories that if a woman takes a two-ingredient pill, she should now change it to a progestogen. Does it make sense?
Prof. dr hab. n. med. Violetta Skrzypulec-Plinta, gynecologist, endocrinologist, sexologist: If you take an estrogen-progesterone pill for at least three months, your body has already adapted to the hormones and the risk of a thrombosis is reduced. The important thing is that if we use hormone therapy, we try not to stop it during a pandemic. Because this, in turn, has other consequences. For example, when we take pills not only to protect ourselves from pregnancy, but also because of heavy menstrual bleeding.
At the end of 2020, an expert position on counseling in the field of hormonal contraception in the COVID-19 pandemic was published based on a review of recommendations of scientific societies. Clinical trials show that in the context of thromboembolic complications, one-component contraception based on progesterone can be considered safer.
Combined contraception most often contains ethinylestradiol in combination with: drospirenone, dienogest, gestodene, chlormadinone, levonorgestrel or norgestimate. On the other hand, single-ingredient tablets previously contained desogestrel, while single-ingredient tablets containing drospirenone are new. There are many methods of contraception: oral, daily, long-term, etc. and it is the doctor’s role to choose the most appropriate one.
If we get infected with COVID-19, should we tell the doctor that we are taking birth control pills?
Absolutely, it’s very important. Regardless of whether our condition requires hospitalization or we are treated at home. The doctor analyzes the situation and decides what to do with it. We are now giving our patients their private numbers so that they can call us when the need arises. Me too. We don’t take any money for it. I believe that we have difficult and unusual times. Empathy, support and understanding is what everyone should be guided by now. So we help as much as possible.
I will also ask about pregnancy. Is a pandemic a good time to have a baby?
I analyzed huge material on pregnant women. We can say that a patient who is after 18-20 tc has a placenta and the fetus is protected to some extent. However, for a woman who is just planning a pregnancy, I would now propose a scheme – vaccination for COVID-19, waiting, and then pregnancy. But there are groups of women whose biological age does not allow them to wait. They are 39 years old, the ovarian reserve is small, so time matters. And here it makes no sense to wait.
When it comes to the very conduct of pregnancy, in the pandemic we learned to steer towards the English side. There, if the pregnancy is physiological, there were no problems with conception, the first visit should take place at 12-14 tc, i.e. during prenatal tests, if the patient agrees to them. And this is a good direction – a delayed first visit, followed by less frequent follow-up visits, reduce the risk of infection. Giving birth in times of a pandemic is difficult for women. Depending on the epidemic situation, family births may or may not occur. Your partner or husband may not always be present at birth. However, those in labor are supported by midwives and doctors. Women give birth, and going home is often expedited, of course, if there are no contraindications for this. In times of pandemic, this is a good solution, as it reduces the risk of contact and contracting COVID-19.
In turn, after giving birth, it is good to take a break from procreation. However, we remember that when breastfeeding, progestational tablets are used, which do not reduce milk production. Contraception is good and useful at different stages of life. To scare her is to take a giant step back.
Also read:
- The six most common symptoms of thrombosis
- Thrombosis and thrombocytopenia following COVID-19 vaccine. Where do they come from?
- Contraceptive pills – action, types and side effects [WE EXPLAIN]
- Asia gives birth in a few days. This is not a joyful countdown
- Americans are giving up the second dose of the vaccine. How many Poles did not come for vaccination?
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