A warning has been issued to women taking the contraceptive pill and doctors who prescribe it, after two women died in the same month from similar complications.
Coroner Alex Ho, in Auckland, New Zealand, has released findings into this week’s tragedies, recommending that women should be counseled about the risks of venous thromboembolism, with both women having unknown blood clotting conditions.
One of the women, Georgia O’Neill, a 24-year-old make-up artist, was found dead by her housemate in her room at her shared flat in Mount Roskill Auckland in September 2021.
Ms O’Neill had texted her housemate and her father earlier that day saying she was feeling unwell and had pain in her lower back running down her left leg. She told her roommate that the pain made her want to throw up.
Coroner Ho said Ms O’Neill was unaware she had a condition known as the Factor V Leiden mutation, which increases the risk of deep vein thrombosis (DVT) or pulmonary embolism (PE) 35 times for those on the pill .
For those without the condition who take the pill, the risk is about three to four times greater.
Coroner Alexander Ho said women should be educated about the increased risk of blood clots while taking the combined contraceptive pill and the symptoms they should not ignore
Dr. Eileen Merriman, clinical director of hematology and lead thrombosis physician at Te Whatu Ora Waitematā, said there is no benefit to routinely screening for Factor V Leiden before patients start using the contraceptive.
This is because most people who have developed a DVT or PE do not have the thrombophilic mutation.
‘The lack of a positive test may therefore falsely reassure those with a family history of venous thromboembolism, where additional risk factors may be present,’ said Dr Merriman. NZ Herald.
In Coroner Ho’s recommendations, he said that all women who have used the combined contraceptive pill, and especially those with a family history of venous thromboembolism, should be vigilant in checking for symptoms and not ignore them.
In the case of DVT, symptoms include leg pain in the thigh or calf, swelling, skin that feels warm to the touch, and has reddish discoloration or streaks.
In the case of PE, symptoms include shortness of breath, rapid breathing, chest pain under the rib cage, dizziness and fainting.
Coroner Ho said women should be properly informed about the increased risk and symptoms to look out for by medical professionals before being prescribed the pill.
He also pointed to the death of the second young woman Isabella Rangiamohia Alexander, 17, who collapsed in the same month while walking with her father.
She was rushed to Auckland Hospital but died shortly afterwards. Blood clots were later found on her legs and lungs.
In the report, Dr. Merriman that, in general, “the consequences of unintended pregnancy can cause far greater harm to women than safe oral contraception.”
‘The risk of DVT and PE during pregnancy is sixty times higher than that of the combined oral contraceptive pill.’