Hormonal birth control not an option — blood clotting disorder

Originally Published: April 25, 2008
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Alice-

I have a blood disorder (leiden factor V) which prevents me from talking any form of birth control with hormones in it. This is a problem as I am very paranoid about getting pregnant, I would like to have a child at some point, but not for 5 or 6 years. Condoms just seem to risky, and diaphragms and female condoms don't work well for me. So I'm not quite sure what to do. I am able to take the plan B pill, and wondered if I can just take it after having sex. Or if there are any other options out there I would love to know about them! Thank you!

— Desperate

Dear Desperate,

While it may be true that having factor V Leiden (a condition that can increase the chances of having blood clots) rules out estrogen-based birth control methods, your situation may not be as desperate as you think. There are other hormonal and non-hormonal methods that might be right for you, and just as effective. Armed with a little information and a discussion about your specific medical history with your health care provider, you can find an effective contraceptive and kiss your pregnancy paranoia goodbye!

One of the potential side-effects of estrogen-based birth control for all women is that it can increase the likelihood of developing blood clots. Women with factor V Leiden are at an increased risk for clots and other complications since estrogen magnifies the symptoms of the disorder. However, some studies suggest that the other hormone commonly used for birth control, progestin, does not carry the same risks.

As of yet no studies confirm definitively that progestin-only contraception is safe for women with factor V Leiden, however many point to that conclusion. In addition it is generally presumed safe for you to take Plan B (as you mention), a progestin-only emergency contraceptive. But while Plan B may be safe, it is not meant for routine use. Its an effective emergency contraceptive, but would be unreliable for continuous pregnancy prevention.

There are other progestin-only options available. "The shot," also known as Depo-provera or Depo, is an injectable progestin-only prescription method of birth control. A shot of Depo can prevent pregnancy for twelve weeks, and typically has a 97 percent effectiveness rate. Progestin-only birth control pills also exist; they are often called the "mini-pill," although several brands are available. 

The IUD (short for intrauterine device) may also be an option for you. An IUD is a small device that a health care provider inserts through the cervix, into the uterus. Once there, it changes the uterine lining, using either progestin or copper, in order to prevent pregnancy, and is effective anywhere from one to twelve years.

You mentioned that condoms make you nervous, but they actually have a 98 percent effectiveness rate when used correctly and consistently, a rate comparable to oral birth control methods. As far as non-hormonal methods of birth control, condoms are a cheap and reliable way to go. If you choose, you can also couple condoms with the use of a spermicidal gel, which would offer very good protection against pregnancy.

Given that you have factor V Leiden, it's a good idea to visit your health care provider or OBGYN to discuss these and other options. If you are a student at Columbia, you can make an appointment through Open Communicator or by calling x4-2284. With a little research and discussion, you too can have a method of contraception that is safe, comfortable, and effective for you.

Good luck!

Alice