Outrun Danger: Why Fit Women Get Blood Clots
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.
What do you think of this story? Leave a Comment.