Although concerns about cancer are usually foremost in the minds of women using OCs, the Pill's effects on blood chemistry are actually a greater cause for worry. Both the hormones in combined OCs are responsible for these problems, but in different ways.
The progestin component of OCs can alter the level of lipids (such as cholesterol) in the blood. Although estrogen works against this effect by increasing beneficial highdensity lipoproteins (HDL) and lowering harmful lowdensity lipoproteins (LDL), progestin opposes the estrogen and does the opposite. Because high levels of LDL and depressed levels of HDL can cause fatty plaque to build up in the arteries, progestins have been implicated as a risk factor for coronary heart disease.
The estrogen component has been linked to a different problem: an increase in abnormal blood clotting, which can block circulation. A blood clot can appear in any blood vessel, but it is especially serious if it occurs in the brain, heart, or lungs.
Clots or blockages to blood flow can lead to serious and sometimes fatal complications that are usually associated with the following risk factors:
Family history of heart attack or diabetes
Previous heart or blood vessel disease
Smoking
High blood pressure
Overweight
Inactivity (either from too little exercise or from being immobilized)
If you have any of these risk factors, you should ask your physician whether the benefits from taking the Pill outweigh the possible dangers. Doctors and private clinics usually make this decision on a case-by-case basis. Public clinics may have stricter rules against giving OCs to women with certain risk factors.
Here is a description of the symptoms you might experience if you are suffering from a blood clot or blockage, and the technical name your doctor might use to describe it. If you think you have one of these problems, seek medical attention as soon as possible.
Headache, impairment of the intellect, visual problems, weakness or numbness— Cerebral infarction (stroke)
Chest pain, difficulty breathing, left arm and shoulder pain, weakness— Myocardial infarction (heart attack)
Calf pain or swelling, heat or redness in the thigh, heat or tenderness in the lower leg, pain— Thrombophlebitis
Chest pain, cough, shortness of breath— Pulmonary embolism
Abdominal pain, vomiting, weakness— Mesenteric vein thrombosis
Headache, loss of vision— Retinal vein thrombosis
Cramps, lower abdominal pain— Pelvic vein thrombosis
