Thursday 6 February 2014

Let's put the "deadly" risk of the pill in to perspective.

This weekend, we saw splashes across newspapers warning the women of Britain about the dangers of their contraceptive pills. Their DEADLY contraceptive pills no less.

Naturally some of the coverage was, at best, highly charged. Contraception is one of those “women’s choices” that the press just loves to scrutinise – “Is your decision to do x going to make you unlovable / infertile /a terrible mother?” etc. Add in some scientific studies with the words “death” scattered in the text and well you’ve got yourself a pretty good front page. 

These recent media stories have somewhat overblown the risks of the contraceptive pill. That is not to say there are no risks – it’s a medicine. All medicines have risks. The key is to balance these risks against the benefits of the medicines - with the pill, it’s that it is a highly reliable way for women to avoid becoming pregnant. And it is also crucial that, in order to enable people to make informed choices, these risks are conveyed in a responsible way, using the best evidence available (I’m looking at you, Mail on Sunday).

So, the controversy stems from a review looking at the available evidence of increased risks of blood clots among women using combined hormonal contraceptives, primarily the pill, but also patches and rings. The review doesn’t reveal anything new - the risks of blood clots have always been known, and they have always been known to be very low. This European-wide review confirmed that, and that the benefits of combined hormonal contraceptives continue to outweigh the risks.

The best medical evidence we have is that the risk of blood clots among non-pregnant women not using combined hormonal contraceptives is 2 women per 10,000 in a year. The risk for non-pregnant women using them is 5-12 women per 10,000. It is that low. And in comparison, the overall risk of blood clots in pregnancy and post birth is estimated at 10-20 per 10,000.

And as for the risk of dying from taking modern contraceptives, the excess risk is 1 in 100,000 women -  much lower than the risk of everyday activities like cycling. 

Women should be told about any risks as part of their decision making process when choosing a method of contraception - we all expect this when we start a new medication – and there will be women for whom combined hormonal contraceptives are not suitable. But the risks overall are incredibly small, the benefits are incredibly large – and the media should stop cherry-picking from scientific research in order to scare women.