Ask a doctor on the topic of Other questions to doctors

Pill after thrombosis due to immobilization?

September 29, 2016 | 20,00 EUR | answered by Dr. med. Ive Dr. Schaaf

Dear Dr. Schaaf,

In October 2015, as a result of immobilization due to a foot fracture, despite receiving Clexane (40mg daily at that time with a body weight of 83kg and height of 1.65m - I have since lost 10kg), I developed a thrombosis in the fibular vein. Treatment: 3 months of compression and Xarelto. The final examination showed complete recanalization of the affected vein.

After the diagnosis of the thrombosis, I immediately stopped taking the contraceptive pill. I am now 31 years old and have been taking the pill since I was 15 without interruption and without any problems (never smoked in my life!). Most recently, I was taking Belara for many years (previously Valette and Neo-Eunomin for my acne).

The different opinions of my treating angiologist and my gynecologist have still not left me at peace, which is why I am seeking your advice today. While my treating angiologist said that the pill could not have been the cause of the thrombosis after such a long time and there was no reason to stop it - the thrombosis was solely due to the immobilization and exacerbated by my overweight (as I mentioned, I have lost about 10kg). My gynecologist advised me to have a Factor V Leiden test (result: negative!) and told me that the pill is now off-limits for me.

What is your opinion on this?

Since I now have a new, steady partner, I long for the pill again and think back to the conflicting opinions of both doctors. Condoms (even though I am currently using them for contraception) and NFP are not for me - I feel too insecure. And the thought of getting a copper IUD inserted scares me, as I am very sensitive to pain and even routine visits to the gynecologist are very painful for me.

Kind regards & thank you in advance!
Ann-Kristin W.

PS: You will probably recommend discussing this issue with my gynecologist. However, my "problem" is that in June of this year, due to work reasons, I moved from Germany to Switzerland and have not yet found new doctors.

Dr. med. Ive Dr. Schaaf

Good evening,

the recommendation to avoid the pill after a thrombosis (from a gynecologist) is correct. BUT: The angiologist is also right, because each case must be looked at individually. It has already been ruled out that a coagulation disorder is the cause of the thrombosis in your case, and as you yourself say, you took the pill without any problems for a long time.

Since it is your wish to take the pill and you are aware of the increased risk, you can take the pill. Your individual risk consists of a little too much weight and the condition after a thrombosis (according to statistics). But here is another BUT: You only had a very small thrombosis, which has completely resolved, so it was "almost nothing".

It is important to continue to watch your weight, not smoke, and ABOVE ALL, wear compression stockings at least in risky situations, and possibly use abdominal injections. Please take a detailed look at risky situations here: [Link provided].

The most common danger is overlooked when one is "just sick", meaning bedridden + fever + not drinking enough!!!

Any further questions?

Otherwise, all the best,

Dr. Schaaf