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August 2, 2011 5:27 PM   Subscribe


I am a mid-30's non-smoking, pretty healthy woman who is returning back to birth control, after a long hiatus. In my 20's, I was given Yasmin to control my PCOS, and help improve side-effects of other metabolic disorders. Since then, I have lost a significant amount of weight, cleaned up my diet, kept consistent with exercise and really regulated my thyroid (I am hypo and have been since I was a kid) and all of my metabolic issues have disappeared.

This time around, I am only taking Yaz for birth control. I went to my gyno and told her that Yasmin had given me no side-effects 10 years ago, which is why she put me on Yaz.

However, reading the internet has freaked me out to the point where I am certain I'll get a blood clot or have a stroke if I continue on with my medicine. I've already experienced minor leg pain and anxiety (though let's be fair, the anxiety is probably caused by what I am reading on the internet.)

Another complication that my gyno might have glossed over - I have nerve damage in both of my legs from a back/spinal cord injury and they generally hurt all the time. So I don't think I would be able to tell the difference between my normal leg pain and the possibility of something like DVT. I've been in the hospital multiple times and have been given ultrasounds during that time on my legs, due to the fact that I was in the hospital for a prolonged period of time. Luckily, they never found anything.

I have a family history of stroke (my grandmother, grandfather and father all passed away from massive strokes) which I did tell my gyno, but didn't seem to raise a red flag. My blood pressure and cholesterol are fantastic.

I am thinking of going to see my regular doctor, as he has treated me for all my non-specific gynecological needs and I feel he'll listen to my concerns.

Am I being paranoid? Are a handful of people on the internet, and a pending lawsuit just scaring me unnecessarily? Do any me-fis have positive (or negative) experiences they can share with me?

I've only been on my pills for a few days, and I'd rather back out if I have to before things really get screwy!
You have to assess the risks and the benefits; anecdotes are not really going to help. Is it likely that you will get a clot? No. Are you increasing your risk? Yes. So now you need to examine what benefits you are getting, and decide if they are worthwhile. There are plenty of other forms of bc with less risk, so consider that too.
posted by yarly at 5:32 PM on August 2, 2011

Well, I've been on it for about 4 years and don't have any side effects other than blissfully short and light periods. I am not dead. Will that help you sleep better tonight? You should probably call your doctor anyway since you have a different body than me!
posted by Green Eyed Monster at 5:37 PM on August 2, 2011

Keep in mind that Yaz (and Yasmin) are among the most widely prescribed and taken brand/type of oral contraceptive, so just because of the sheer huuuuuge numbers of women taking them, there's more attention given to their side effects. It doesn't mean that other types don't have risks - all have some risks of something. But lesser common pill brands just won't get the same kind of focus.

I've been on Yasmin (or its generic form 'Ocella') for 4 years, and am 31. No side effects. But you could not pay me ever go back on Ortho Tri Cyclen, which messed me up big time when I was on it. Unfortunately, the pill is really a lot of trial and error, and talking to your doctor. Give it some time. See how you feel. And trust that.
posted by raztaj at 5:48 PM on August 2, 2011

Are you going to want to get pregnant soon? If not, there's always the IUD option to consider. In the US, there are two: the Mirena, which is hormone-based and lasts for 5 years (side effects can include not having periods at all and some women rarely have systemic effects due to the hormones), and the Paragard, which is copper-based and lasts for 10 years (side effects can include heavy periods and cramps).

There's an awesome LiveJournal community for IUD users and seekers if you're interested.
posted by Addlepated at 6:09 PM on August 2, 2011 [1 favorite]

The NuvaRing is/was my favorite, but my new insurance doesn't cover it. The medication is released more locally than in other hormonal BC methods, and this supposedly reduces the risks of side effects. Also, YMMV but the Mirena IUD gave me terrible ovarian cycts and I had to go back to pills after 5 months. DepoProvera made me constantly nauseated. Again, just my personal anecdote, FWIW.
posted by wowbobwow at 6:53 PM on August 2, 2011

Undiagnosed clotting disorders are surprisingly common. (The specific kind I have is shared by about 5% of Caucasian women, for example). I don't have any kind of medical expertise, but I suspect that a lot of the strokes/DVT caused by hormonal birth control are related, if not to smoking, then to various kinds of clotting problems.

So, I wonder if your gyno would be able to run a blood test to screen for clotting problems? Might that give you some peace of mind?
posted by Jeanne at 7:30 PM on August 2, 2011

This is totally anecdotal, but I was wary for years about hormonal birth control. Finally I went on it and have had literally no problems. I started talking to friends about it and most of them were like "yep, I've been on it for years, no biggie." This was the thing that made me realize that people don't go on the internet to talk about how they took a drug and it was unremarkable (well, with the exception of me, right now). Definitely talk to your doctor if you're concerned, but the vast majority of people who take HBC have no issues.
posted by lunasol at 7:38 PM on August 2, 2011 [1 favorite]

IANAD, but I've tried a lot of pills, and now have a non-hormonal IUD, which I wish I'd gotten ten years ago.

The nonhormonal brand is Paragard. Mirena is the other brand, and in addition to providing a physical barrier to conception, it releases a progestin. If you are sensitive to different brands of birth control, it may be because you are sensitive to the different progestins they use (all birth control, except progestin-only pills, use the same estrogen, although in different doses--what's different is the type of progestin). You might first test-drive a hormonal pill that uses levonorgesterel, the type of progestin used in Mirena. Levonorgesterel is used in Nordette, Seasonale, and Plan B. This is also the type of progestin used in progestin-only pills, if you want to get away from the estrogen entirely. (I believe estrogen is the culprit in blood clots, but please confirm with a doctor, because I'm not one.)

The only reason I would try the pill before committing to Mirena is because it's no picnic getting an IUD if you haven't had a baby (but still totally worth it, IMHO), and if you're unhappy with the hormonal side effects, you can't just stop taking them--your doctor has to remove it.

But obviously a lot of women have no problem with Mirena, so YMMV.
posted by thinkingwoman at 7:47 PM on August 2, 2011

I can only answer anecdotally, but Yasmin was the first birth control I was ever prescribed. Two months in, I was having daily very painful leg cramps. And it made me a crying mess. It wasn't until a few years later, when I was mostly-happy on other birth control (it made me prehypertensive, so I dropped HBC completely a few years later) that I realized it might have been something to be genuinely concerned about.

If you're freaking out about it, I don't think it can hurt to ask your doctor to switch you to a non-drospirenone based hormonal birth control. There are many options, and while I think it's easy to discount the experiences of women who have had genuine health problems on this one, I also would be a bit hesitant to turn to something with such a storied history.
posted by PhoBWanKenobi at 8:40 PM on August 2, 2011 [1 favorite]

I've been taking generic Yasmin, and I have PCOS. I've seen those "BAD DRUG" tv commercials and warnings about blood clots and, yeah, they're something I think about. But honestly, I do not worry about them. (A disclaimer, perhaps, is that I love what that pill does for me.) Ask your doctor what a blood clot feels like. Tell them you're a little freaked out by things you've heard about blood clots and Yaz/Yasmin, and you'd like to not be. You're happy with the pill (I gather), but you'd like to be more aware of the blood clot risk for you personally.

Keep in mind that ALL hormonal bcps will increase your risk for blood clots. Yaz/Yasmin was found in a couple studies to increase the risk twofold compared to other birth control pills, but the absolute risk is still quite low, especially considering you are not overweight and you don't smoke.

And everyone does it, but stop scaring yourself reading anecdotes on the internet!
posted by eldiem at 9:07 PM on August 2, 2011

I think it would definitely be a good idea to talk this over with your doctor, if only to relieve your anxiety. If you're worried about blood clots, you might ask him if a lower-dose pill would be a safer bet for you. I'm on Lo-Estrin (which I believe is the lowest dose pill available) for PCOS and have been for about 15 years with no problems (and I'm 46, much older than you). The downside with the low-dose pills, I've found, is that they aren't very forgiving; you need to be pretty much 100% consistent about taking it at the same time every day. If I take a pill late, say by 3 or 4 hours, I have a heavier, crampier period; it's not the end of the world, but it's noticeable.
posted by WorkingMyWayHome at 9:18 PM on August 2, 2011


This is precisely what my gyno said when I brought it up with her, FWIW.
posted by naoko at 11:41 PM on August 2, 2011

Incredibly anecdotal, but I've been in your shoes and here's how I allayed my fears. This spring, the Internet started freaking me out about the pill for whatever reason.

I mentioned my concern to my gyno, basically acknowledging that I knew the level of risk was super small but asking if there was something else that would do the same job with a lower risk, and she blew me off and sent me home with another year's script. I just felt uneasy about it in general because my questions hadn't been answered, so I made an appointment at Planned Parenthood. They basically said, "You don't have to worry about being on the pill because of X, Y, and Z reason, but if you're going to worry about it anyway we can show you all these other options," and they helped me figure out how to switch up my birth control. I'm just as happy with what I'm using now as I was with the pill and much less worried about blood clots.

I'm not saying this to proselytize for getting off the pill, at all. My advice is rather that you find a doctor who will discuss these concerns with you frankly to either give a risk analysis you can live with, or help you figure out what you should switch to. I think a decent number of gynos, for reasons ranging all over the map, tend to push the pill without really taking the time to discuss what might be the best option for each individual patient. It's really worth it to engage in the trial and error of finding a gyno/women's health clinic who will take the time to treat you as an individual and work with your concerns, whether or not you end up staying on the pill.
posted by superfluousm at 9:02 AM on August 3, 2011 [1 favorite]

Everyone will be different, but I will tell you my experience with Yaz. Five years ago (I was 40, non-smoker), I took Yaz for a few months for mood control, not birth control. It wasn't doing the trick, so I stopped taking it.

Soon after, I started noticing that I was short of breath when walking--even short distances. It kept getting worse instead of better. The doctor diagnosed me with pneumonia (w/o an x-ray) and put me on an antibiotic, but it didn't get better. So, he was going to send me for asthma testing.

Before that date came around, it got worse, until one morning (9/15/06) I passed out. My husband caught me on the way down, my son called 911 and I was taken to the hospital via ambulance. After much testing, they found that I had MULTIPLE clots in BOTH lungs. They didn't find them anywhere else, which is commonly where clots start--legs, especially.

After being told all the REALLY scary possible side effects, I chose to have the "clot buster" medication (thrombolitic) and we waited for the crucial 2 hours to see if it would work safely or if I would start bleeding internally. This medication saved my life.

I was in the hospital for a week while the doctor regulated my Coumadin, which I had to take for the next 6 months (which has its own scary possible side effects!). He confided to me late in the week that I had the worst case of clots that he had ever seen--especially for being a 40-year-old woman--and he shared with me how close I actually was to dying that first night.

He was not able to find ANY other cause for my clots, other than the Yaz. I had not been traveling (sitting on a plane or in a car for an extended length of time). I had not had a recent surgery. Blood clots were not a genetic issue. The only other possible factor that could be a contributing factor was undiagnosed (at that time) Celiac Disease (intolerance to gluten--the protein in wheat, rye, barley, & oats); however, this is not a proven link to blood clots and many doctors won't even acknowledge this as a possibility.

So, I'm not saying that this is going to happen to you...but it DID happen to me and I thought you might want to hear my side of it. Hope it helps.
posted by Mrs. Smith at 10:32 AM on September 8, 2011


Since we're adding to this thread ... I just wanted to point out for posterity that this comment is incorrect. Yaz is thought to have an increased risk of clots over the older forms of the pill. It is NOT just a matter of more people being prescribed Yaz. In absolute numbers the risk is small, but as Mrs. Smith's story shows, blood clots are no joke. (I also have an acquaintance who got a clot after Yaz and it is very, very serious.)
posted by yarly at 10:53 AM on September 8, 2011

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