Women on birth control pills could be at a higher risk of dying if they are exposed to coronavirus, experts have warned. It is already well known that some types of birth control can increase the risk of blood clots.
But researchers say that being infected with Coronavirus disease (COVID-19) causes the threat of blood clotting to be even higher.
Doctors have been learning more about the virus as the pandemic unfolds, but studies show that it can cause clots, also known as thrombosis, and could be contributing to the number of people who are dying.
Medical experts have previously warned that up to a third of patients who are seriously ill with COVID are developing thrombosis. Now, new research from the US suggests that pregnant women, taking the Pill or on hormone replacement therapy (HRT) face the same danger.
Study co-author, Dr. Daniel Spratt, of Maine Medical Center in Portland, United States of America (USA), said: “During this pandemic, we need additional research to determine if women who become infected during pregnancy should receive anti-coagulation therapy – or if women taking birth control pills or hormone replacement therapy should discontinue them.”
Coronavirus can cause blood clots to form – even in previously healthy people, said Spratt.
What is more, oestrogen fuels potentially deadly deep vein thrombosis in some mothers-to-be – and in women using the pill or Hormone Replacement Therapy (HRT).
The blockages usually start in the legs, but they can move up – triggering a heart attack or stroke. Oral contraceptives are known to carry a small risk of the condition – which may be exacerbated by the coronavirus, according to the paper published in the journal Endocrinology.
Announcing their findings, the team said: “If infected with Covid-19, these women’s risk of blood clotting could be even higher.”
Spratt said: “Research that helps us understand how the coronavirus causes blood clots may also provide us with new knowledge regarding how they form in other settings and how to prevent them.” The links between blood clots and COVID-19 – including the effects of oestrogen therapy or pregnancy – are complicated. Spratt said several studies using innovative animal and tissue models will be required to shed light on them.
Birth control pills remain the most popular method of contraception in the UK – despite alternatives such as injections and implants.
More than three million British women take them at any one time, despite potential side effects ranging from depression to mood changes. They also carry up to a fourfold increase in a woman’s chance of developing a blood clot.
Most contain oestrogen and a synthetic form of progesterone – the hormones that sustain pregnancy and, by imitating the condition, prevent it. But they also raise clotting factors. For the average woman, the absolute risk of a blood clot just one in a thousand – but the threat of coronavirus may raise this significantly.
Spratt said: “As more information emerges regarding the effects of COVID-19, questions arise as to whether infection aggravates blood clots and strokes associated with combined oral contraceptives and other oestrogen therapies, as well as pregnancy-associated risks.”
“Rates of strokes double from about four to eight in 100,000 young women a year, while similar figures have been found for older women on HRT.”
Spratt said: “In pregnancy, the risk of blood clots increases four to fivefold. The mechanisms for these and the duration of the effect after discontinuing therapy remain unclear.
“A common recommendation is to discontinue oestrogen-containing preparations two weeks before planned activities that may cause thrombosis such as surgery or long flights.”
He added: “Conversations between clinicians, researchers, endocrinologists and haemotologists are necessary to explore potential interactions between COVID-19 and pregnancy or oestrogen therapy that could guide management.”