How And Why YAZ, Yasmin, And Ocella Pills Might Cause A Higher Rate Of Blood Clots In Women

Estrogen Combined With New Progestin Drospirenone (DRSP) May Increase Risks Of Serious Side Effects Like Pulmonary Embolism, Stroke, And Heart Attack

Although all hormonal birth control options are associated with some health risks, the oral contraceptive pills YAZ, Yasmin, and Ocella have the distinction of being associated with a possible higher rate of blood clots. In turn, blood clots can cause serious side effects from using oral contraceptives like YAZ, Yasmin, and Ocella – namely, stroke, heart attack, pulmonary embolism, and deep vein thrombosis. The obvious questions are “How?” and “Why?”.

A blood clot, or thrombosis, in any part of the body can be extremely painful. A blood clot which begins in one part of the body can become a thromboembolism – essentially a blood clot that moves. A clot which moves into the lungs, heart, or brain is a very serious condition which can be fatal, i.e., result in death.

In more detail, deep vein thrombosis, or DVT, is a blood clot which most commonly forms in the leg. A pulmonary embolism – often called PE by medical providers – is a dangerous condition in which a clot forms in or has moved into the lungs. When a clot reaches the heart it can cause a heart attack, and clots in the brain can lead to strokes.

There are four possible reasons, or ways, that YAZ, Yasmin, and Ocella are suspected to increase a woman’s risk for thrombosis and thromboembolism: estrogen / progestin combination; DRSP’s link to hyperkalemia; the serum copper concentrations; and, DRSP’s diuretic effect.

(1) Unique Estrogen and Progestin Combination

Estrogen is a hormone which increases the coagulation of blood. Estrogen combined with a progestin enhances this effect even more. This is why all hormonal contraceptives are associated with some risk for developing blood clots.

YAZ, Yasmin, and Ocella are the only oral contraceptive (OC) pills to contain drospirenone (DRSP), which is a new progestin classified as a “fourth generation”progestin. It is widely held that the newer third and fourth generation progestins carry a higher risk for blood clotting.

YAZ, Yasmin, and Ocella are advertised as clearing mild acne and decreasing water retention, in addition to serving as a means of birth control. As such, the added risks of OC pills with DRSP are often overlooked by women when choosing these contraceptive, or birth control, pills.

In fact, the consumer advocacy group Public Citizen recommends that practitioners rely upon older, well-researched oral contraceptives. They state that there is no reason to opt for more potentially dangerous contraceptive pills, when there are safer options which are equally as effective. YAZ and Yasmin have both made Public Citizen’s Do Not Use list in the past.

(2) Hyperkalemia Due to DRSP

Drospirenone (DRSP) exhibits antimineralocorticoid activity. This influences the regulation of water and electrolytes in the body. Further, this type of activity can increase potassium to a dangerous level, putting a woman at risk for hyperkalemia.

Hyperkalemia is a dangerous condition which develops when there is too much potassium in the blood. Potassium is essential in regulating a normal heart rhythm. However, when too much potassium is present in the blood, suppression of electrical activity of the heart, or heart failure, can result.

When the electrical rhythm of the heart is disturbed, blood can pool in the walls of the atrium. Over time this pooling can cause blood clots to form. Clots in the heart put one at a greater risk for having a heart attack, or myocardial infarction (MI).

The package insert, or label, for YAZ, Yasmin, and Ocella each currently carry a bolded warning for their link to hyperkalemia. What these warnings do not mention, unfortunately, is how even mild hyperkalemia can increase the risk for blood clots.

(3) Serum Copper Concentrations

Studies have shown that people who have higher serum copper levels also face a greater risk of death from cardiovascular disease. It is already well-established that women using oral contraceptive pills have higher levels of serum copper. However, some new studies are showing that certain types of birth control pills increase those copper levels more than others. In particular, the culprit pills are those containing antiandrogenic progestins like drospirenone (DRSP). This antiandrogenic quality of DRSP is a main selling point for YAZ, Yamin, and Ocella because it is supposed to be superior in reducing the androgenic effects, such as hair growth and acne, of many other oral contraceptive pills. But this “superior” antiandrogenic progestin DRSP also appears to increase the risk for dangerous cardiovascular and thrombotic (blood clotting) side effects.

From the 2009 article, "Effects of oral contraception with ethinylestradiol and drospirenone on oxidative stress in women 18-35 years old", published by the medical journal Contraception:

The recently introduced combination of ethinylestradiol and drospirenone [in YAZ, Yasmin, and Ocella] induced the heightening of lipid peroxidation correlated with high levels of copper, a situation that could be associated with increased cardiovascular risk.

And from the European Journal of Clinical Nutrition, here is a 1998 article, "Effect of oral contraceptive progestins on serum copper concentration":

While elevated serum copper concentration was found in users of all types of oral contraceptives, elevation was more pronounced among women taking oral contraceptives with antiandrogen effective progestins like antiandrogens or third generation oral contraceptives.... Further investigation is required to shed light on the possible role of high serum copper concentration in increasing cardiovascular or thrombotic risk of women using oral contraceptives.

(4) Drospirenone’s Diuretic Effect

YAZ, Yasmin, and Ocella are said to be innovative oral contraceptive pills insofar that they contain the new progestin drospirenone (DRSP) which claims to get rid of the uncomfortable, painful bloating and water retention normally associated with a woman’s period. However, DRSP’s diuretic effect – which causes the body to rid itself of water – poses another potential danger for clotting.

Water is a large component of the blood. It aids in keeping the blood at its proper consistency which, in turn, allows it to flow, and coagulate, in a normal way. When the body becomes dehydrated, however, the blood thickens. Thus, again, the risk for blood clots increases.

For these reasons, each of the four factors above plays a part in the safety concerns that have arisen concerning YAZ, Yasmin, and Ocella. Further, this potential for an increased risk of dangerous blood clotting side effects like DVT, PE, stroke, and heart attack is something that prompts some people to ask whether the current warnings included on the labels for YAZ, Yasmin, and Ocella are sufficient?

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