Abu Dhabi, UAE: Women need to be aware of the health risks posed by oral contraceptive pills and take warning signs seriously, say doctors.
The risks include blood clots, deep-vein thrombosis, heart attacks and strokes in women who are smokers, especially if they are over 35 years of age.
Milder risks include spotting between periods, weight gain or fluid retention, nausea or mood changes. Blurred vision, severe stomach pains, headache, swelling or pain in the legs or chest pain are also some possible side effects.
Dr Soraya Farah, obstetrician and gynaecologist at Serenity Clinic Foetal Maternal Care, said there were factors to weigh up before using an oral contraceptive pill [OCP].
“Some women have serious medical conditions, like history of breast cancer, endometrial cancer, unexplained vaginal bleeding, liver tumours or disease, increased clotting or stroke risk, and should not use OCPs.
“Others might be at higher risk for side effects due to age or smoking status. They should speak to their health care provider before taking pills. Women of any age should avoid combination hormonal birth control if they have a history of uncontrolled high blood pressure, chest pain, diabetes and severe headaches.”
She agreed that the pills should not be provided without a prescription.
“Before being handed a prescription a woman should have a detailed history including family history, general and gynaecological examination,” she said.
“Major factor risks and contraindications should be detected. Regular check up including blood test is recommended to reduce mortality and morbidity.”
She added that these kinds of side effects were rare.
Dr Nazura Siddiqi, specialist obstetrician and gynaecologist at LLH Hospital, Mussaffah, said: “It is important to understand that though there are serious health risks, they occur in an extremely minute number of cases. However, every woman should be screened by a doctor before being given a prescription.”
Dr Fady Georges Hachem, consultant – obstetrics and gynaecology at Burjeel Hospital, also added that OCPs could increase chances of certain cancers, although it reduces risks of others.
“The breast cancer risk increases slightly and uterine cancer and ovarian caner risk goes down with oral contraceptives,” he said.
“If you are on the pill you are more fertile as they protect the ovaries. They also protect the ovaries from infection.
He also pointed to the risk of deep-vein thrombosis.
“The risk is related to the dose of oestrogen in the pill and the type of progesterone in the pill. The third generation pill with the third generation progesterone has a higher risk of DVT than older pills.
“The risk is six to 10 people out of 100,000 people,” he said.
“Abu Dhabi has done a good job of making it mandatory to have a prescription. The doctor has the role to choose the suitable contraceptive method after assessing risk factors and looking at history and a full examination,” he said.
According to the National Health Service in the UK, about one in 1,000 pregnant women develop DVT at some point during their pregnancy.
The combined contraceptive pill and hormone replacement therapy both contain the oestrogen. Oestrogen causes the blood to clot slightly more easily, so one’s risk of getting DVT is slightly increased.
© The NationalMar 2015