Gasping for breath, 23-year-old Charlotte Foster collapsed at her workplace and was taken by ambulance to hospital. Three days later, she was dead. A coroner ruled after her death in January this year that the business graduate from Shropshire, whose family described her as “lively, intelligent, beautiful and caring”, had suffered a “massive” blood clot in her lungs caused by the oral contraceptives she had begun taking only a few months earlier.
Last month, another inquiry ruled that her GP, Sunil Simon, who saw Foster three weeks before her death and recommended she go for a “spa day” for what he thought was muscle pain, had failed to recognize the Pill’s extensively documented deadly side-effects.
Although embolisms (clots) from the Pill are not exactly commonplace, thousands of women have suffered these serious adverse events. Foster’s case is a tragic illustration of how, despite decades of marketing the Pill as one of the 20th century’s greatest medical achievements and a symbol of women’s liberation, its most dangerous drug side-effects have still not gone away and are instead frequently overlooked, even by the doctors who prescribe them.
What’s more, the Pill’s increased risk of serious heart attacks, strokes and pulmonary embolisms have proven to be at the far end of a broad spectrum of nasty side-effects, ranging from blurred vision and gum disease to depression, weight gain and loss of libido.
New generation, old risks
In fact, while the general perception is that the Pill has become safer than it was when it was first introduced, newer versions of the Pill are proving to be even more dangerous than their predecessors.
Foster was reportedly taking ‘new-generation’ Dianette—also known as Diane-35 in the US and Canada—which contains cyproterone (a form of the female hormone progesterone) and ethinylestradiol (an oestrogen), which effectively suppress the actions of testosterone and have contraceptive effects. In both the UK and Canada, Dianette is also approved as a treatment for acne when antibiotics and other topical treatments have failed, but its use for this should be limited to just one year.
An inquiry following the deaths of four girls taking Dianette in France revealed that this acne medication was also being widely prescribed as a contraceptive, but the elevated risk of blood clots resulted in its being banned from the market there.
There are no figures for how often Dianette is prescribed incorrectly in the UK, but Foster is not the first British woman whose death has been linked to the drug. It has been found to have caused at least seven other deaths, including that of Charlotte Porter, a 17-year-old taking the drug for acne, who collapsed in agonizing pain and died in March 2010 from a blood clot in her lungs caused by deep vein thrombosis (DVT). Her doctor had dismissed the white spaghetti-like veins in her leg because he thought she was too young for DVT.
In Shannon Deakin’s case, her GP diagnosed the swelling and redness in her left thigh and “knife-like” pains as an infection. She was prescribed antibiotics and anti-inflammatory drugs, but died 12 hours later.
Higher risk of blood clots
Studies have linked Dianette to a sixfold greater risk of developing a blood clot compared with non-users of oral contraceptives,1 although nearly all oral contraceptives come with heightened risks. And the risks climb as you add in other known risk factors. Among women who had used oral contraceptives, the risk of a heart attack was nearly 14 times higher among those who smoked, for example, and 17 times higher in those with diabetes and 25 times higher in those with high cholesterol.
Two other so-called ‘new-generation’ birth-control medications from Bayer, Yaz and Yasmin, are formulated with a new, synthetic progesterone and are widely marketed to preadolescents and upwards as a treatment for acne. They’ve become global best-sellers within the past decade.
But it wasn’t long after their introduction that adverse-event reports began pouring in, including claims of Yaz-related strokes, heart attacks and gallbladder disease. In Canada, the Canadian Broadcasting Corporation (CBC) obtained government documents showing that, between 2007 and February 2013, doctors and pharmacists reported 600 adverse reactions, including 23 deaths where Yaz or Yasmin were the suspected cause. More than half the reported deaths were women aged under 26, with the youngest being just 14. Most of them had only recently started taking the contraceptives.
One young woman, 18-year-old Miranda Scott, suddenly collapsed while on an elliptical machine at a University of British Columbia gym. On autopsy, her body was found riddled with blood clots, and the coroner ruled that a blood clot in her lung had killed her.
But it was her mother who made the connection with her daughter’s taking Yasmin just over a month earlier. “And that was all it took, five weeks start to finish, and that was the end of a beautiful, beautiful girl,” she told the CBC.
Scott’s was one of the more than 13,000 lawsuits alleging serious harm, including blood clots, strokes, heart attacks and gallbladder damage, from these two drospirenone-based contraceptives. Plaintiffs have routinely argued that the drug maker hid the known risks to young women and girls.