FSRH statement in response to press reports on risk of blood clots for users of the combined contraceptive pill during the COVID-19 pandemic
Date: 19 Mar 2021
Type: FSRH Press Releases and Statements
Concerns about COVID-19 vaccines and blood clots have been in the news . Some media outlets have also reported on the risk of blood clots for users of the combined contraceptive pill. That has worried some individuals who use combined hormonal contraception (CHC), because they know that their combined contraceptive pill, skin patch or vaginal ring can increase risk of blood clots too.
Summary
- Individuals using CHC are at a small increased risk of having a blood clot, but the numbers of clots that happen because people are using CHC is very small.
- Severe COVID-19 infection increases risk of blood clots. It is possible that milder COVID-19 illness might too. Unless they are severely ill in hospital, individuals with COVID-19 should not stop their CHC suddenly without switching to other effective contraception, because that could put them at risk of unplanned pregnancy. We advise them to ask their doctor about switching to another method of contraception.
- People using CHC should continue it when they have their COVID-19 vaccination.
- Anyone worried about risk of blood clots may consider using effective contraception other than CHC
Contraception and risk of blood clots
The risk of someone having a blood clot when they are using combined hormonal contraception (CHC) is really small – much smaller than the risk of having a blood clot if they were pregnant. Nevertheless, people are slightly more at risk of a blood clot when they are using CHC than they are when they are not using it, even if they are fit and healthy. Therefore, some individuals choose to use one of the other effective kinds of contraception instead. The progestogen-only pill, the implant, the injection and intrauterine contraceptives do not increase risk of a blood clot.
Covid-19 infection and risk of blood clots: what should CHC users do?
Individuals who are very ill with COVID-19 have an increased risk of blood clots. If someone is in hospital with COVID-19, we recommend that they do not use CHC in case it increases the clotting risk even more.
We do not know what the blood clot risk is for people who have mild or asymptomatic COVID-19 infection or people who have recently had COVID-19, but it could be higher than normal. That could mean an added risk of blood clots for people that are using CHC who become infected with COVID-19.
It is really important that people do not stop their CHC suddenly because they are worried about blood clots – that would put them at risk of unplanned pregnancy. Instead, if someone has a mild COVID-19 infection, they could ask their doctor for the safer progestogen-only pill to use until they are completely well again.
People who don’t have COVID-19, but are using CHC and are worried about the risk of clots if they did get COVID-19, can speak to their contraception provider about switching to another kind of contraception. They should keep using their CHC until the new contraception is started.
COVID-19 vaccination in CHC users
Most recently, there has been concern that a COVID-19 vaccine might cause blood clots although we don’t know for certain that it does, and the risk seems to be very low. We don’t know that using CHC makes any difference to that risk. We recommend that people who are using CHC when they have their COVID-19 vaccination continue using their contraception as normal to avoid risk of unplanned pregnancy.