What COVID-19 vaccine blood clots reveal about women’s health

As rare cases of blood clots are reported from COVID-19 vaccines and medical agencies pause or ban their use in certain groups, women are speaking up about the great risk of their own birth control. It’s raising some vital points about how women are treated in medicine.

As a young woman of 28, I can now be offered an alternative vaccine e.g. Pfizer or Moderna when my time comes to be vaccinated against COVID-19.¹ That’s because a lot of the reports of blood clots after vaccines have been in people my age.

As these developments have been reported and announced, a lot of questions about the safety of other drugs have been raised. One in particular, The Pill as well as other forms of contraception, has been bought up time and time again.

But, can we really make direct comparisons between vaccines and hormonal birth control?

The differences in blood clots

With the Oxford/Astra Zeneca vaccine, the types of blood clots that have been reported are clots in veins of the brain (known as cerebral venous sinus thrombosis), clots in the veins of the abdomen (splanchnic vein thrombosis) and in some arteries.² What’s more, low levels of platelets (which help to create clots in case of an injury e.g. a cut) have also been reported.²

Hormonal contraceptives, on the other hand, are linked to other kinds of blood clots. These venous thrombi typically lead to deep vein thrombosis or pulmonary embolisms (a clot in a lung artery), and clots in the brain are much rarer.^3,4 Pills that contain both oestrogen and progesterone seem to have the highest associated risk of blood clots, but all forms of hormonal contraceptives, except for the hormonal IUD/IUS (something like Mirena), carry a risk.^3,4 Overall, hormonal contraceptives increase the chance of a blood clot by 3 to 9 times, depending on what you use.³ To put that into real terms, that means that 300–400 women in the United States will die from a clot because of their contraceptive every year.³

The sexism of medicine

Raising questions about the risks of The Pill is part of a wider, essential conversation about how women are treated in healthcare systems.

For example, women are often underrepresented in clinical trials.⁵ They’re often left out in case their fertility is put at risk (which makes a sexist assumption that all women are fertile and want to have children). This means that most drugs that are approved for use in both men and women are often based on just male evidence. Women are therefore at risk of being overmedicated⁵ and also seem to experience more side effects in clinical studies.⁶ So, surely, we need to include more women in trials and look at how a drug interacts and affects this group – and I don’t just mean ‘girly drugs’ like contraceptives.

What’s more, women’s pain is viewed and treated very differently.^6,7 Women have a higher prevalence of chronic pain and diseases associated with pain than men, and are more sensitive to pain than men.⁷ Despite this, what they say is taken less seriously and men tend to receive more aggressive treatments.⁷

Men are more likely to hold off on going to a doctor when something may be wrong.⁷ Women, despite going to see a doctor or nurse sooner or more often, are more likely to be brushed off as ’emotional’ aka ‘making a fuss about nothing’.⁷ Obviously, these feelings of physical pain are just in our pretty lil’ heads!

And here’s a top tip, ladies. If you’re unwell and need to see a doctor or nurse, don’t try to look presentable. Look bad. Look REAL bad. Women who look physically attractive are less likely to be believed when they say something is wrong.⁷

Where do we go from here?

Sadly, by the time that I’ve published this post, the outrage will have mostly died down about the risk of contraceptives to women’s health.

That being said, it’s important to speak up for yourself if something is wrong. It could be nothing, but it could be something. If you don’t feel that you’re being heard or taken seriously enough, get another opinion.

We need to be advocates for ourselves and for each other. We need be advocates for the health of all sexes and genders.

Thanks for reading! Sign up to Pandora’s Health for even more advice, tips and tricks about the latest trends.

1. GOV.UK. MHRA issues new advice, concluding a possible link between COVID-19 Vaccine AstraZeneca and extremely rare, unlikely to occur blood clots. Available at: https://www.gov.uk/government/news/mhra-issues-new-advice-concluding-a-possible-link-between-covid-19-vaccine-astrazeneca-and-extremely-rare-unlikely-to-occur-blood-clots. Accessed April 2021.
2. European Medicines Agency. AstraZeneca’s COVID-19 vaccine: EMA finds possible link to very rare cases of unusual blood clots with low blood platelets. Available at: https://www.ema.europa.eu/en/news/astrazenecas-covid-19-vaccine-ema-finds-possible-link-very-rare-cases-unusual-blood-clots-low-blood. Accessed April 2021.
3. Keenan L et al. Systematic Review of Hormonal Contraception and Risk of Venous Thrombosis. The Linacre Quarterly. 2018;85(4):470–477.
4. Gialeraki A et al. Hormonal Contraceptives and HRT Risk of Thrombosis. Clinical and Applied Thrombosis/Hemostasis. 2018;24(2):217–225.
5. Zucker I & Pendergrast BJ. Sex differences in pharmacokinetics predict adverse drug reactions in women. Biology of Sex Differences. 2020;11:32.
6. Ruiz-Cantero MT, et al. Gender bias in therapeutic effort: from research to health care. Farmacia Hospitalaria. 2020;44(3):109–113.
7. Hoffman DE, et al. The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain. Journal of Law, Medicine & Ethics. 2001;29(1):13–27.