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The pill has a higher risk of causing blood clots, but nobody is banning that

Concerns over the AstraZeneca vaccine have exposed medical gender bias at its worst

Emma Flint
Friday 09 April 2021 09:23 BST

In the last few days, we’ve seen another Covid-19 discourse arise – this time surrounding the AstraZeneca vaccine and its risk of blood clots. As many stood waiting to get vaccinated with this very brand, the news broke that several EU countries were suspending, and even banning, its use. Naturally, panic ensued.

Yet, there’s little panic over the contraceptive pill, a medicine that has a higher risk of causing blood clots, and is used on a daily basis across the world. The countries pausing the use of AstraZeneca don’t seem to be as concerned about the rate of blood clots caused by the pill. 

According to Clue, a widely used period tracker, blood clots arise from the pill in four to 16 users out of 10,000 each year. More than 10 million people have been vaccinated with the AstraZeneca jab so far, with, according to the Healthcare products Regulatory Agency (MHRA), 30 cases of thromboembolic events reported so far following administration. That’s a low number. Really low. To put it into perspective, the National Blood Clot Alliance estimates that 1 in 1,000 people will naturally experience deep vein thrombosis (DVT) per year.

Despite data proving that the risks from AstraZeneca are low, this news only helps to reignite earlier misinformed notions that these vaccines weren’t rigorously tested. Not even the European Medicines Agency (EMA) and the World Health Organisation (WHO) reiterating that its benefits outweigh the risks has helped.

However, for those of us who’ve been presented with the “side effect” of blood clots from the pill – and yes, they refer to it as a side effect – the news doesn’t scare or surprise us. What does alarm us is the blatant medical gender bias at work.

Dr Sumera Shahaney, GP and head of clinical operations at Thriva, recalls an example of medical gender bias during her own pregnancy. Dr Sumera had to raise an issue with her intended treatment because her pregnancy wasn’t taken into consideration. She was set to undergo a treatment with a risk of radiation, but had to “flag a problem with this” herself rather than the team on hand doing so. 

Throughout history, it’s been cis men who’ve determined the majority of women’s medical experiences. We’ve been excluded and secondary for centuries. This same disregard is still prevalent today, but now we’re challenging it. 

If you talk to the majority of women who’ve taken the pill, both for contraception and HRT (hormone replacement therapy), they’ll tell you that blood clots are deemed “acceptable”. It’s assumed it’s part and parcel of our existence.

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I went on the pill at 14 years old, and was never once warned about blood clots. The doctors told me about possible weight gain and irregular bleeding, but neglected to mention the far more distressing side effects that could come from this medication. Sadly, I’m not alone in this experience. 

I’ve asked other women for their experiences – nobody I spoke to was warned about blood clots, or any side effects at all. “I wasn’t told initially [about blood clots] when I was prescribed [the pill], but read about it in the leaflet,” Cath Poucher shared with me.

A similar story came from Kate Rice: “I was not actually told about the risk of blood clots when I first went on the pill at 15. I wasn’t really warned about any side effects, I was just [given them] and told to hope for the best”. Just “hope”. It makes me shudder.

Many who work in healthcare know all about medical gender bias. At my last cervical screening, the nurse remarked that “if men needed to have smear tests, the process would be simpler. Less invasive and uncomfortable”.

It’s my belief that if cis men had to take the pill, had to put up with the risk of blood clots in the same way we do, it might be suspended or banned. After all, when male contraception was being tested, trials were stopped because the side effects were deemed too risky.

Perhaps the only difference between the pill and the AstraZeneca vaccine is that cis men are now considering nasty side effects? Countless women who take the pill have been scared about side effects for most of their lives.

Over the coming days, I’m certain the debates about AstraZeneca will rage on. However, for those of us who sit with uncomfortable medical side effects on a daily basis, we see the bias, we see the current panic, and we wonder if our issues will ever be treated with the same concern.

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