The oral birth control Beyaz is essentially Yaz (drospirenone / ethinyl estradiol) plus a folate dietary supplement. The contraceptive is more than 99% effective at preventing pregnancy when used correctly, but the risk of pregnancy goes up when it is not taken at the same time every day. Beyaz contains folate to reduce the risk of birth defects (specifically, neural tube birth defects) in case of pregnancy.
All women who take Beyaz are at risk of suffering from a Venous Thromboembolism (VTE). However, you may not have been aware of the risk of Beyaz VTE when you decided to take Beyaz. This is because many “fourth generation” contraceptives were advertised without risk information. In fact, it was only recently (in April of 2012) that the FDA updated the label to warn of the three-fold increased risk of blood clots associated with Beyaz.
What is a Venous Thromboembolism (VTE)?
A Venous Thromboembolism (VTE) is actually a series of events that combines Deep Vein Thrombosis (DVT) with a Pulmonary Embolism (PE).
A Beyaz VTE begins when the hormones in Beyaz cause red blood cells, platelets, and other substances to bind together along the walls of veins. Over time, a blood clot begins to form, despite the lack of injury. Deep Vein Thrombosis (DVT) occurs when the blood clot grows deep inside the body, usually in veins in the calf, thigh, pelvis, or upper arm. Blood in the thigh are most dangerous; approximately half cause pulmonary embolisms.
A pulmonary embolism (PE) occurs when a blood clot is broken loose and travels in the bloodstream. Veins carry blood to the heart, which pumps blood into the lungs. If there is a blood clot in the blood, it will get stuck inside smaller blood vessels inside the lungs. The severity of the PE depends on the size of the blood clot. A large clot can block most circulation to the lungs, causing severe tissue damage.
The heart may also be damaged. During a severe PE, the heart is forced to generate very high blood pressure to overcome the blockage. It must beat very hard and fast. If it is not strong enough, a Beyaz VTE may cause heart failure, cardiac arrest, and death.
Signs & Symptoms of a Beyaz VTE
The symptoms of VTE include the symptoms of DVT and PE. However, not all cases of DVT show symptoms. In fact, about half are symptomless. The lack of symptoms can increase the risk that a woman will delay seeking treatment. Other times, the woman knows something is wrong, goes to the hospital, and the doctor fails to diagnose the blood clot before it causes a deadly pulmonary embolism.
The symptoms of a Beyaz VTE include:
- Pain, tenderness in the extremities (usually, legs or arms)
- Discoloration or redness of the affected area
- Increased warmth in the affected area
- Rapid pulse
- Shortness of breath
- Chest pain
- Profuse sweating
- Cough, which may be bloody
- Anxiety, apprehension, feeling like something is wrong
Treatment & Prognosis
If a Beyaz VTE has already occurred, the goal of treatment will be to restore circulation to the lungs and prevent more blood clots from traveling into the lungs. It is likely that they doctor will use aggressive intravenous medications that dissolve clots. Sometimes, large clots can cause massive disruption to the circulation in the lungs, and there is a danger that the condition can cause sudden death. In these cases, surgery may be necessary to remove the clot.
One complication of severe DVT is Post-Thrombotic Syndrome, in which blood clots damage the blood vessels in the lower legs. Chronic side effects include temporary pain, swelling, varicose veins, itching, and tingling.