A couple of years ago, I was put on the third-generation contraceptive pill Yasmin. ‘It’s good for your skin and stabilises your weight,’ the doctor said. And it’s true. I’ve found it to be wonderful. Most of my friends are on similar types of third–gen pill, like Femodene and Marvelon; many swear by them. Out of the 3.5 million women in the UK using the combined contraceptive pill, 1 million are on third–gen versions. But things aren’t all rosy. In the past week, all British GPs have been ordered to warn anyone taking these popular pills that they are at risk of developing potentially fatal blood clots.
‘The annual risk of a woman of childbearing age having a serious blood clot is 1 in 5,000 if she is not on a combined contraceptive pill. The risk triples to about 1 in 1,700 a year if she is taking one of the older forms of combined pill, and taking third generation pills means the risk doubles again, to as high as 1 in 800.’
The risk of blood clots is included in the labelling for these pills, so the drug companies are not technically at fault. If you are at high risk of having a stroke – you smoke, are overweight, or have a family history of the condition – it's unlikely that you will be put on the pill. But the sheer volume of women taking these third-gen pills is startling. They have become hugely popular because some people have viewed them as kind of a beauty supplement. There are women who take pills like Yasmin not because they require contraception, but because they believe it will improve their skin or help them lose weight. The trade off – the known risk of blood clots – can seem minor.
The pill can be a woman’s best friend. It puts you in charge of your own fertility and has saved countless women from unwanted pregnancies, dodgy abortions and more children than they can handle. It’s played a major role in engineering gender equality, allowing women to enjoy sex in the same way men can – without fear of pregnancy.
Over the years, the pill has evolved, and there are now numerous options available. It’s a confusing world, and finding one that suits often relies on trial and error. But in recent years, third-gen pills like Yasmin have become highly sophisticated, designed to reduce some of the unwanted side-effects traditionally associated with earlier varieties of pill - mood swings, bloating, headaches and bad skin.
But when I speak to my doctor about Yasmin, she is adamant that in my case I must come off it immediately, despite the fact that I should not be at high risk of having a stroke. ‘Blood clots can be very dangerous. They can cause severe health problems, including strokes and heart attacks.’ She explains how young women have no concept of how devastating a blood clot can be, and so are continuing to ignore the fact that third-gen pills can be hazardous.
One woman who knows this well is Georgie Holland. She was a healthy, active girl, who never smoked or drank. Aged 17 and a half, she suffered a severe stroke. It has left her with limited peripheral vision in her right eye, and areas of her brain have been permanently damaged. It is impossible to say what caused Georgie’s stroke; but she began taking Yasmin at age 16, and her family believe that the drug may have contributed to her condition.
Sarah Scott suffered a stroke in 2009, aged 18. She did not appear to be at risk of a stroke. There was no history of stroke in the family, she was a non-smoker, not overweight, she ate healthily and went to the gym. Sarah’s stroke was severe, and has left her with the communication disorder aphasia, which affects her speech, reading and writing. As in Georgie’s case, it is impossible to establish what caused Sarah’s condition; but her family believes that Yasmin, which she had begun to take a few months before her stroke, could have been a contributory factor. They are campaigning for greater awareness about the risks of third-gen pills.
In September last year, 19-year-old Rosie Carter died of an epileptic seizure. She was taking Yasmin at the time. Her family believes that the drug may have played a role in her death because she had never experienced seizures prior to taking it. They want to make young women aware that there may be risks associated with certain types of pill. The inquest into Rosie’s death continues.
There have been similar incidents in America. In July 2012, it was reported that Bayer, the pharmaceutical company that manufactures Yasmin, had said that legal settlements in the US over claims that Yasmin caused blood clots had increased to more than $402 million. This news followed an order given by the US Food and Drug Administration in April 2012 that Bayer and other contraceptive makers make blood clot warnings more prominent on their packets.
When asked to comment on these issues, Bayer referred The Spectator to a company press release which stated that a recent decision by the European Commission on combined hormonal contraceptives supports its view that 'no new scientific evidence has emerged that would change the positive benefit-risk assessment of combined hormonal contraceptives.' In addition, the press release noted that the commission had said that the risk of arterial thromboembolism (blood clots in layman's terms) is ‘very low’ and that there is 'no evidence that different types of proestogens are associated with a different level of risk'. But the company also said that it would 'update the product information, including the package leaflet, to provide additional information to women and prescribers on the known risk of thromboembolism and its risk factors, signs and symptoms.'
Meanwhile, Britain’s drugs watchdog has informed the country’s 60,000 GPs that they now must follow a checklist when prescribing third-generation pills. Whether this would have prevented Georgie and Sarah’s strokes is unclear – both of them should not have been at risk of having a stroke. Perhaps GPs need to conduct further tests when prescribing contraceptive drugs? An annual checkup which included a coagulation test could perhaps be brought in to check that women are not at risk of developing clots.
All drugs have side effects. And there is always a balance of risk and benefit. In the case of third-gen pills, the beauty benefits can be enticing. But women should be aware that their choice of contraception can have dangerous side effects. British GPs now have a hard task ahead of them – persuading women that the ‘dream pill’ may not always be worth it. I was reluctant to come off Yasmin – but my doctor’s sombre advice eventually trumped my vanity.