Brittany Malone was a healthy 22-year-old woman when she suddenly developed a blood clot in her right thigh, which traveled into her lungs, causing a pulmonary embolism that left her brain dead. After extensive medical testing on her and her family members, Brittany’s parents, Dana and Joe, believe that her death was caused by the hormonal contraceptive vaginal ring she was prescribed. The family is now working to raise awareness about the risks associated with the popular contraceptive and hope to get the manufacturer to add a new label on the product warning of the potentially deadly side effects.
The hormonal contraceptive vaginal ring is one of the most popular forms of birth control in the world. It is a clear, flexible ring that fits inside the vagina and releases a combination of hormones over three weeks that prevents ovulation. It is a third generation progestin birth control, and contains the hormone etonogestrel, which carries a higher risk of blood clots than earlier forms of progestin found in the first and second generations of birth control products. While other products that carry this same heightened risk are required to have a warning label on the packaging explaining this risk, the FDA does not currently require the vaginal ring to have this warning label.
“We don’t want their money … We want them to do what’s right. We want them to fully disclose the risks associated with this product,” Joe says.
“There is no such thing as zero risk,” Dr. Ashton says, “so you always want to pick an option with your health care provider that minimizes the risk and maximizes the benefits.”
Facts about hormonal contraception:
• First generation birth control pills became available in the 1960s and contained only estrogen, which increased the risk of blood clots by nine-fold.
• Second generation birth control pills became available a decade later and contained a lower dose of estrogen and added progestin, a synthetic hormone. This change in composition made these pills safer and gentler than the first generation.
• Third and fourth generation birth control products were developed to control certain body conditions caused by hormonal imbalances, such as excessive facial hair growth and acne.
Pros of taking the pill:
• 91-98% effective at preventing pregnancy
• Makes menstrual periods lighter and more regular
• Reduces the risk for ovarian and uterine cancer, pelvic inflammatory disease, ovarian cysts and anemia
Cons of taking the pill:
• Does not protect against sexually transmitted infections
• Requires strict and consistent dosage times
• Can cause side effects, such as nausea, increased appetite and breast tenderness
Pros of using the vaginal ring:
• Provides a steady stream of hormones
• Is used month to month, instead of daily
• 91-98% effective at preventing pregnancy
Cons of using the vaginal ring:
• Cannot be used by women with diabetes, liver problems, or a history of cardiovascular events
• Higher risk of blood clots
Alternate forms of birth control:
Intrauterine devices (IUDs) are small, T-shaped devices made of flexible plastic that are inserted by a health care provider into a woman’s uterus to prevent pregnancy. There are two types available in the United States: the ParaGard IUD, which contains copper and is effective for 12 years; and the hormonal IUD, which releases a small amount of progestin and is effective for three to five years.
Pros of using an IUD:
• 99% effective at preventing pregnancy
• Single application can last for several years
• Lessens menstrual flow
Cons of using an IUD:
• Needs to be inserted by a health care provider. In rare cases, the device can sometimes fall out.
• The copper IUD can have side effects such as menstrual cramping.
Condoms are single-use sheaths that are rolled over a man’s penis to prevent semen from entering the vagina. They can be made of either latex, polyurethane or lambskin, and are disposed of after each use.
Pros of using a condom:
• Reduces the risk of contracting a sexually transmitted infection
• Has almost zero side effects, except for a latex allergy
• No prescription needed
Cons of using a condom:
• Can break or tear
Sources: americanpregnancy.org, livestrong.com, womenshealth.org, youngwomenshealth.org, plannedparenthood.org, nuvaring.com, National Institutes of Health