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Outrun Danger: Why Fit Women Get Blood Clots

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Protect Yourself

Fortunately you don't have to ditch birth control or swear off flying to prevent blood clots. Instead, follow these simple steps.

Stay active. The longer you sit still, the more sluggish your blood flow and the greater the chance of a clot. If you have a desk job, tapping your toes or bouncing your knee at least every hour will contract your calf muscles and kick-start circulation, says Christopher Kabrhel, MD, an associate professor of surgery at Harvard Medical School. Exercise lowers the risk of clots even if you're mostly sedentary, he adds, so hit the gym after a long workday.

Choose the aisle seat on planes. You'll be more apt to stand up and stretch your legs, which will get your blood pumping. Also, take catnaps instead of conking out for the entire flight; your lungs are more efficient at taking in oxygen -- and therefore your circulation is better -- when you're awake. If you're flying before or after a hard workout or race, wear compression socks and loose clothing and stay hydrated.

Check out your birth control. Does it contain drospirenone, a synthetic version of progesterone? Newer pills that do, such as Yaz and Yasmin, pose two to three times the risk of DVT/PE than older oral contraceptives with levonorgestrel, a different synthetic progestin, two recent studies found. Vaginal rings and skin patches double the odds of getting a blood clot compared with the lower-risk pills, according to a Danish study, possibly because the amount of estrogen absorbed from patches is 60 percent higher than the amount delivered by oral contraceptives.

While the absolute risk of a blood clot is still small for the average woman on birth control, it pays to take precautions, says ob-gyn Dr. James. When choosing a contraceptive, discuss with your doctor any other blood clot risk factors you have -- such as being over age 35, a smoker, overweight, or having a family history of DVT/PE -- and then consider the odds. Readdress birth control with your doc if your risk factors change in the future, especially if you're immobilized or have an injury, Dr. James says. And in that case, consider switching to a progestin-only IUD, like Mirena or Skyla, or a mini-Pill, neither of which raises blood clot risk.

Speak up. If you will be undergoing surgery, ask your doctor what precautions he is going to take to protect you from blood clots. And if you're on hormonal birth control, tell the surgeon. She may suggest that you go off it temporarily.

Watch your left leg when you're pregnant. Researchers at the University of Toronto found that of the 124 cases of pregnant women with DVT that they studied, nearly 90 percent had the condition in their left leg. During pregnancy, more blood clots occur in the left leg because an artery overlying a vein there obstructs blood flow. If your left leg hurts, swells, or turns red suddenly, all signs point to a clot. See your physician immediately or go to the ER. To prevent clots after delivery, walk around as much as possible as soon as your doctor says it's OK.

Interview your family. Have your grandparents, parents, or siblings had DVT/PE? A family history of the condition puts you at a somewhat increased risk, so inform your MD.

Treat varicose veins. Blood flows more slowly through an enlarged vein, increasing clot risk sixfold. Talk to a vascular surgeon about removing any bulging veins, or ask your doctor for a prescription for medical support hose to help prevent clots.

Listen to your body. "If something feels wrong, have it checked out," Dr. Moll says.

Kara now realizes that it should have been a red flag three years ago when her leg pain didn't improve with rest and ibuprofen. "My biggest mission now is to tell people that the pain in your leg can kill you," she says. "You need to pay attention to it and get help."

For more information, go to these websites to get additional facts about blood clots:


Originally published in FITNESS magazine, November/December 2013.


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s.kerschieter wrote:

I had a friend who passed away at 39 and was an active runner. She had several doctor appts and didn't find it. So, without symptons, can we request any test to evaluate? CT is the best way to know.

12/16/2013 01:29:05 PM Report Abuse
hales33 wrote:

I echo Kristine's comments. I am a DVT and PE survivor after a left ankle-to-groin DVT and fist-sized saddle embolism in my lungs. I was 27 years old, and doctors didn't know if I was going to make it through the night. People make the assumption that you can only get blood clots because you're over weight. I'm a former college athlete and was in better physical shape at 27 than I was at 21. Know the signs.

11/25/2013 01:14:40 PM Report Abuse
kristine0891 wrote:

As a PE survivor, I want to thank Fitness for this article and bringing attention to such a serious issue. At 27, I developed multiple PEs following hip surgery. I spent the next 6 days in the hospital. Like these women, Iżm a runner and had run a Half 8 weeks prior. If it can happen to fit, young women it can happen to anyone. I'm lucky to be alive. I strongly urge everyone to be aware of not only your risks, but also the warning signs. Early detection and treatment is the key to surviving.

10/30/2013 07:03:54 PM Report Abuse

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