France sees 11% drop in pulmonary embolisms as women flee newer contraceptive pills

The so-called 'micro-pills' were front page news two years ago after a woman revealed she suffered a stroke from taking them.
Thu Nov 13, 2014 - 2:44 pm EST
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There was a significant drop in the number of women aged 15 to 49 seeking help for pulmonary embolism in France last year: 11.2 percent fewer women were taken to hospital in 2013 compared to the previous year. The National Agency for Drug Safety (Agence nationale pour la sécurité du medicament or ANSM) was expecting such a decrease, which it has linked to reduced use of third and fourth generation contraceptive pills since March, when the French social security stopped refunding the so-called “micro-pills.”

Pulmonary embolism occurs when a blood clot travels to the lungs and causes respiratory distress, damage to the lungs, paralysis and even death, according to the size of the clot.

The link between deep-vein thrombosis – which can cause the potentially fatal condition of pulmonary embolism – and progestin-only contraceptives was brought into public notice in December 2012 by Marion Larat, a woman who survived a stroke induced by her oral contraceptive. Being a whistle-blower is not enough – but in her case the mainstream media picked up the story when it made the Monde’s first page. The young woman fell ill when she was 18; at 26 and nine operations later, she had recovered the ability to speak and to use her limbs and was ready to go public. It was only in 2010 that Larat was told by her gynecologist that the “micro-pill” she had been taking had put her at a greatly increased risk of thrombosis, especially as she has a genetic abnormality of the coagulation of the blood.

“It made me angry! Why wasn’t anyone talking about this?” she wrote.

In the wake of the scandal – a number of other girls and women came forward to tell of similar incidents – the ANSM recommended a halt to public funding of the pills, and their use fell sharply (by 45 percent), also because of media attention.

The ANSM commissioned a report on pulmonary embolism in 2012 and 2013, expecting to find a 10 percent decrease in morbidity related to the condition among the population that previously used third and fourth generation pills. The findings of the report were consistent with the ANSM’s expectations among women aged 15 to 49. Control groups consisting of men aged 15 to 49 and women aged 50 to 69, who typically do not use oral contraceptives, showed no drop in pulmonary embolism over the same period.

In total, the ANSM says about 341 hospitalizations for pulmonary embolism were averted thanks to the lesser use of third and fourth generation pills in 2013: 2,704 women were hospitalized compared to 3,045 in 2012.

The largest decrease was observed among women aged 15 to 19 (a 19.1 percent drop), and those aged 20 to 29 (a 12.0% drop), who are more frequent users of the supposedly better-tolerated third and fourth generation pills.

Progestin-only pills induce more very early abortions than the “classic” pill, their action consisting mainly in modifying the lining of the uterus to make it hostile to the implantation of the embryo, seven days after fertilization.

Over 2013, the ANSM notes, overall sales of contraceptives have scarcely diminished (about 1 percent). While 45 percent less third and fourth generation pills were sold, sales of first and second generation pills rose by 30 percent. Sales of oral contraceptives in general decreased by 5 percent but long-term contraception is on the rise: intra-uterine devices (IUDs) and contraceptive implants went up 28 percent.

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These statistics give the lie to media reports accusing the media scandal about third and fourth generation pills of having provoked an increase in abortions. “4% more abortions, 10,000 women victims,” said the mainstream media after an article in the Journal de Gynécologie obstétrique et biologique de la Reproduction said that many women suddenly stopped taking these pills as a result of media hype. The study referred to statistics from 11 abortion centers where 2,300 women were said to have attributed their abortion to having stopped using contraceptives because of the negative reporting. The number of 10,000 quoted by the study is an extrapolation.

In France, where over 90 percent of fertile, sexually active women are contracepting, a large proportion of abortions – over 72 percent – are performed on women who use some form of contraception.

Interestingly, the announced 4 percent increase in abortion was presented as unwelcome. “The consequences of a ‘voluntary interruption of pregnancy’ are far from negligible: apart from definite psychological repercussions, they often entail durable physical side effects,” writes the popular health site, e-sante.

The study does not monitor a possible increase in abortions due to measures implemented by the socialist government to make them “more accessible,” including 100 percent refunds for the act which is now free for all women, increased payments to doctors and gynecologists who perform the act, and more public-funded information in favor of abortion.


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