ASH Clinical News December 2016 | Page 89

TRAINING and EDUCATION Patient Education WOMEN and the RISK of BLOOD CLOTS Nearly 900,000 people are affected by blood clots each year, leading to approximately 100,000 blood clot-related deaths annually. Dangerous blood clots such as deep-vein thrombosis (DVT) often form in the veins of a person’s arm or leg. If a DVT is left untreated, the clot can break loose and travel to the lungs (pulmonary embolism [PE]), which can be life-threatening. Men have a higher overall risk of thrombosis than women, but women have risks due to pregnancy, birth control, and postmenopausal hormone therapy that men do not. These risks are generally attributed to estrogen, a key ingredient in birth control pills, patches, and rings, and in postmenopausal hormone therapy. Choices related to family planning, pregnancy, and the treatment of menopausal symptoms can affect a woman’s risk for developing a blood clot. This is further increased if a woman has previously experienced a blood clot, has a family history of blood clots, or has been diagnosed with a genetic or acquired clotting disorder. Nearly half of people who experience a DVT do not experience symptoms, so it is important for women to learn the risks associated with blood clots. Read below for more information about the risk factors for developing a blood clot that are specific to women. This “Patient Education” tear sheet was produced in collaboration with the National Blood Clot Alliance (stoptheclot.org). In both men and women, certain factors increase a person’s risk of experiencing a blood clot, including: • hospitalization • surgery • traumatic physical injury • immobility • smoking • obesity • older age • family history of clotting disorders Symptoms of blood clots in the legs or arms include pain and swelling, and skin may be discolored and/ or warm to the touch. Symptoms of blood clots in the lungs include chest pain (particularly when taking a deep breath), coughing up blood, shortness of breath, and an accelerated heart rate. Birth Control and Family Planning Birth control methods that contain estrogen (i.e., birth control pills, patches, and rings) and synthetic progesterone (progestin) can increase a woman’s risk for blood clots because they cause an increase in the level of clotting factors or clotting proteins in a woman’s body. The most common method of birth control in the United States is the birth control pill, and the vast majority of women taking estrogen-containing birth control pills will not experience a blood clot. The absolute risk of developing a blood clot is about 1 in 300 women. Some newer birth control methods, such as patches and rings, pose an even greater risk because the amount of estrogen absorbed from the patches is reported to be 60 percent higher than the amount of estrogen delivered by pills. Safe birth control methods that do not include estrogen include: • barrier methods • spermicides Cut out and give to a patient • progestin implant • copper intrauterine device (IUD) • progestin IUD ASHClinicalNews.org ASH Clinical News 87