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RougeGarbageMouth t1_irredyi wrote

Hi Professor Hunt! My question is not specifically about the MTHFR mutation, but is a little more general about to the increased risk of thrombosis with hormonal birth control. Are you aware of research being done on ways that this can be minimized or new classes of birth control that don’t carry the same risk? For many women who are taking BC for medical reasons (other than to prevent pregnancy), there are not many good alternatives if clotting proves to be an issue. Long term non hormonal birth control methods (specifically copper IUDs) carry their own issues with extremely heavy periods, made even worse if a patient is on anticoagulants - and of course, they don’t treat the hormonal issues that estrogen BC would. As a woman who falls into this category, it is hard not to feel left behind.

Edit: Typo

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WorldThrombosisDay t1_irs03kd wrote

Sorry you are having problems. The options to estrogens for birth control for people who have had previous clots or have had a thrombophilia are: progestogen only pill, progesterone implants, coils (I find the coils such as the Mirena coils particularly good), and mechanical methods. The only method you can't uses is the combined oral contraceptive pill.

Many thrombosis experts would offer the combined oral contraceptive pill if the woman had no other option and they were taking long-term anticoagulation because they had already had a clot.

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