As we’re talking about blood clots, where is the government’s energy to improve the pill?

The government’s announcement that under-30s should take an alternative to the Astra-Zeneca (AZ) vaccine where possible, due to the risks of blood clotting, has been met with feelings of irony, confusion, and frustration by many people taking the oral contraceptive pill. 

The decision comes after 79 cases of blood clots and 19 deaths have been reported from the 20 million people who have received a dose of the AZ vaccine. This puts the average blood clot risk at 0.0395 in 10,000, or just under four in a million people. 

It goes without saying that every life lost to side effects from the vaccine is devastating, and the government’s dedication to pay attention to these risks and encourage safer alternatives is, undeniably, a positive thing. 

However, it does raise the question: Why has this attention not been given to the contraceptive pill following so much evidence that it can cause life-threatening side effects?

According to the NHS website, one of the most high-risk factors for blood clots is the contraceptive pill – the UK’s most common form of contraception, taken by 28 per cent of women aged 15 and 49. Around one in 1,000 people taking the contraceptive pill are at risk of experiencing a blood clot, putting the risk of most contraceptive pills at 100 times greater than the AZ vaccine – which isn’t entirely inconsequential. 

Yet, many of us have been prescribed the contraceptive pill with relative ease – at school, the question was not “are you on the pill?”, but “what pill are you on?” – and there’s little discussion of the side effects. At 13 I was prescribed Rigevidon for period pains. I remember the doctor asking if I had a family history of strokes, due to the risk of blood clotting. When I explained that I did, since my dad had suffered a mini-stroke in his 30s, I wasn’t discouraged from taking the pill, merely advised to “keep an eye out”. 

I’m not alone in this though: Anna, a student from Liverpool, told The Tab that following being put on Rigevidon and experiencing side-effects of bleeding for “eight months straight” their concerns were dismissed as being “just hormones” for eight months, until a blood test confirmed they had a blood clotting disorder, which was considered life-threatening when mixed with Rigevidon, and later led to them having a stroke at 20. 

Another woman shared their story on Instagram, saying she “had a CVST and stroke at 18 because of the pill”. She said she didn’t feel that she had been adequately informed about the risks of the pill beforehand, saying: “It was only after I had very nearly died from the clot and stroke that anyone talked to me about the link between birth control and blood clots”.

These aren’t just one-off anecdotes though, and the side effects of the contraceptive pill aren’t just limited to blood clots. Of course, the potential for side effects is a normal and expected part of medicine but when I don’t know a single person who has been on the pill without experiencing some form of negative side effects. It feels like not enough energy is being put into making people aware of the risks, let alone working to counter them. From weight gain, depression, migraines, mood swings, acne, low libido – the list of side effects attached to the packet has become a bit of a running joke, but still, it feels like the risks aren’t being taken seriously. 

Rather, it’s just accepted that these are the things we have to put up with. This is reinforced by suggestions, like those of  Dr Peter Arlett, head of data analytics at the European Medicines Agency (EMA), that the pill should be used as a “benchmark” to consider the risks with the AZ vaccine.  Comparing the two provides a useful insight into the risks associated sure, but perhaps rather than ending the conversation with the fact we should accept the risks of the AZ vaccine because they are relatively lower than the pill, we could actually put some of this energy into improving the pill and the health of those who take it. Everybody’s reaction to the pill is different, but surely it shouldn’t be normal for such an overwhelming majority of users to have negative experiences? 

Some, like Professor Adam Finn from the Joint Committee on Vaccination and Immunisation (JCVI), describe taking the pill as being a “choice” by women of “how they are living their lives”. But when so many women are encouraged, expected, or even pressured to take the pill as a form of contraception, it doesn’t always feel like a choice. Regardless, it certainly shouldn’t be the case that just because we’re taking the pill as a form of contraception we should blindly have to put up with any and all side effects of it, without the hope of it ever improving. Likewise, for trans women undergoing hormone therapy, the NHS list blood clotting as the most common side effect.  Information about these risks isn’t new – the pill has been around for over 60 years – but where is the energy going into alleviating them? 

If you’re wondering whether the dismissal of the risks of the pill could just possibly be rooted in misogyny within the pharmaceutical industry, you might not be far off. It doesn’t fall on deaf ears that a clinical trial for a male contraceptive pill was pulled a few years ago due to its side effects, which ironically included depression and acne – two of the most common side effects experienced by those taking the contraceptive pill. It doesn’t feel like a huge coincidence that action is taken the minute medication starts affecting straight, white cis men. 

Of course, the government shouldn’t completely ignore the potential side-effects of the AZ vaccine or dismiss people’s valid concerns – this isn’t an either-or situation – but can they please start putting similar energy into protecting people on other medication with potentially dangerous side effects?

Featured image credit: Reproductive Health Supplies Coalition (before edit) and Daniel Schludi (before edit)

Related articles recommended by this author:

• These are the contraceptive pills with a higher blood clot risk than the AZ vaccine

• Girls are finally ditching Rigevidon: The contraceptive pill screwing them over

• Girls coming off the pill during lockdown are seeing how much it messes with their bodies