Arterial thrombosis/thromboembolism

Thrombosis can form not only in veins, but also in arteries. Arterial thrombosis frequently occurs in combination with an existing disease, arteriosclerosis. Arteriosclerosis is also known as “hardening of the arteries” and is a chronic disease in which the artery walls thicken and harden. As a result, the blood vessels become more and more narrow, restricting the flow of blood and making it easier for a blood clot to form and block the artery. Arterial thrombosis can also be caused by injuries to the blood vessels, inflammations or infectious diseases. Arterial thrombosis, too, is a known, but very rare side effect of hormonal methods of contraception (pill, ring or hormone patch) and can lead, for example, to heart attacks or strokes.

Arterial thrombosis like stroke or heart attack, is very rare in young women and only affects one or two women out of 10,000 to 100,000 a year. Studies have summarized that the very rare risk of a heart attack during use of combined pills is approximately twice that compared to women who do not use hormonal contraceptives (Tanis et al. 2001, Khader et al. 2003). There is no unequivocal proof of whether the risk of stroke is increased in the absence of additional risk factors such as smoking and high blood pressure (Chan et al. 2004). Most epidemiological studies showed no increase in the risk of stroke among women who used low-dose combined pills.

Personal risk factors for arterial thrombosis include

advanced age smoking fat metabolism disorders diabetes high blood pressure

migraine with aura overweight personal or family predisposition valvular heart disease atrial fibrillation

Symptoms of an arterial thrombosis can include:

• sudden pain in the area of the heart
• a loss of feeling and movement control, sometimes combined with a severe headache
• pain, paleness, coldness and lack of pulse in the arm or leg
• loss of the ability to see or speak

If acute symptoms of this or a similar kind occur, and there is no other evident cause, medical advice must be sought.
Furthermore, the package inserts of combined pills also provide information on side effects and risks. Any unanswered questions should be discussed with a physician.