In April, the Johnson & Johnson Covid-19 vaccine received scrutiny after six women experienced a rare blood clot condition, causing the United States to pause its distribution “out of an abundance of caution.” Immediately, some trying to downplay the risk compared the J&J vaccine to hormonal birth control. 

“For perspective, here are some numbers:

1 in 1,000,000: J&J vaccine

1 in 3,000: oral contraceptives

1 in 5: hospitalized COVID-19 patients

As someone who got the J&J vaccine 8 days ago, and who took oral contraceptives for 20 years, I’ll take these odds.”

— Dr. Angela Rasmussen (@angie_rasmussen) April 13, 2021

While the type of blood clot apparently caused by the J&J vaccine and those caused by birth control are different types of clots, I couldn’t help but wonder if the comparisons to birth control blood clot risk would bring more attention to the often downplayed but quite serious health risk of the most highly prescribed drugs in the world. Saying birth control causes more life-threatening blood clots than the J&J vaccine isn’t quite a ringing endorsement for the vaccine, I thought, since birth control-caused blood clots take a significant number of women’s lives yearly!

According to a 2019 systematic review of the scientific literature led by Dr. Lynn Keenan of the University of California, San Francisco, 136 to 260 healthy women die from venous thromboembolism (VTE) caused by hormonal birth control every year. “When that risk is combined with the added risk of stroke and heart attack, between three and four hundred women die every year in the United States due to their choice to use hormonal contraception,” Dr. Keenan explains.

Between 300-400 U.S. women die annually because of hormonal birth control

The stunning numbers of 300-400 U.S. women lost yearly bears repeating, because birth control’s connection to blood clot risk is so little known and discussed, both from doctors prescribing the contraceptives and from the drug manufacturers’ inserts themselves. All of the drug inserts in hormonal contraceptive prescriptions mention blood clot risk, but they often do so in ways that obscure the level of risk for the average woman. Many birth control warnings note, for example, that the drug “may increase your risk of blood clot, especially if you are a smoker,” leading women to think if they don’t smoke, they’re safe. But, while smokers do experience a higher risk than non-smokers, all women on hormonal contraceptives experience a higher risk than women not on hormonal contraceptives—a fact that is significantly downplayed. (Birth control providers often compare the risk to pregnancy risk of blood clots, which is higher than birth control’s risk; but this isn’t a fair comparison since no person is constantly pregnant for ten years straight the way young women commonly take birth control, not to mention how one is a cocktail of synthetic hormones and the other is a natural state of reproductive health.)

It’s misinformation like this about birth control side effects and health risks that led a group of physicians to submit a Citizen’s Petition to the FDA on May 10, 2019, calling for greater transparency about the risks for women who are prescribed birth control.

As Madeleine Coyne explains at Natural Womanhood, “the goal of the Citizen’s Petition is to compel the Food and Drug Administration to better inform all prescribers and consumers of hormonal birth control of its possible (and even likely) evidence-based health risks, whether in the form of a pill, patch, implant, shot, IUD, or vaginal ring.”

At the time of this article’s publication, the FDA petition is still open for comment for people whose lives have been affected by adverse reactions to hormonal contraceptives. And among the 158 comments currently publicly available, there are some shocking stories. 

One woman named Laura posted this comment:

“2 years ago, my daughter died from a blood clot in her brain caused by the birth control, Yasmin. It was prescribed to her for acne and she believed it was safe. She had no risk factors, no clotting disorders. In the hospital, the doctors told us they see 3-5 patients EVERY WEEK with blood clots from birth control. That’s one hospital in a small metropolitan area in Wisconsin. I can’t imagine what other hospitals are experiencing. Unfortunately, in the last 2 years, I have met several other mothers who lost their daughters to birth control and many others who almost did. Yasmin is still on the market. WHY?!? So many of these contraceptives need to be removed from the market and further studies need to be done. There needs to be SAFE options for women.”

Another woman, named Stacey shared this:

“I had a deep vein clot in my left forearm directly linked to my use of the vaginal ring. . . My only knowledge of blood clots and birth control was that smoking increased the risk of blood clots while on birth control; I am not a smoker. I also experienced severe mood swings and depression, and weight gain, on depo-provera, these symptoms being down-played by my doctor as normal during the use of birth control.”

Numerous girls and women are exposed to birth control risks as the default of women’s healthcare

 While some may view the risks of birth control worth it for the pregnancy protection, such a choice is only possible if the woman has been given full informed consent to the risks. Unfortunately for many young women, they are prescribed the birth control Pill, patch, implant, IUD, vaginal ring, or shot simply as a standard of care for being female, and without full knowledge of the risks. Even for teen girls who are not sexually active, general practitioners and OBGYNs alike will recommend birth control as a means of regulating the menstrual cycle (which it doesn’t do), or treat any number of conditions such acne, cramps, and so on. And the American College of Obstetricians and Gynecologists currently recommends long acting reversible contraceptives (LARCs) such as the Nexplanon implant or intrauterine device (IUD) for adolescent girls.

Not only are these girls young, impressionable, and influenced by peers also taking these drugs, they can put a lot of weight into their doctor’s recommendation, which may not include a full disclosure of the risks. And when they start experiencing common birth control side effects such as depression, anxiety, or other mood disorders, their doctors often dismiss them as non-issues or prescribe antidepressants.

For a long time, women and girls experiencing contraceptive side effects and adverse health risks haven’t had their concerns taken seriously. For the 300-400 U.S. women dying annually from blood clot and cardiovascular-related events related to their choice of birth control, their voices are forever silenced. One can only hope that their loved ones’ voices shared on the Citizen’s Petition to the FDA  for greater transparency will be heard.