When you start taking a birth control pill like desogestrel-ethinyl estradiol, you’re not just preventing pregnancy-you’re changing how your body handles hormones. That shift can have real effects, and one of the most serious concerns is blood clots. It’s not common, but it’s real enough that you should understand it before you start, or if you’re already on it.
What Is Desogestrel-Ethinyl Estradiol?
Desogestrel-ethinyl estradiol is a combination hormonal birth control pill. It contains two synthetic hormones: desogestrel is a progestin, and ethinyl estradiol is a form of estrogen. Together, they stop ovulation, thicken cervical mucus, and thin the uterine lining. It’s sold under brand names like Cerazette, Marvelon, and others depending on your country.
This pill is popular because it’s effective, often causes lighter periods, and can help with acne and PMS. But like all estrogen-containing birth control, it carries a small but measurable risk of blood clots. That risk doesn’t mean you shouldn’t take it-but it does mean you need to know the signs and your personal risk level.
How Blood Clots Form With Hormonal Birth Control
Estrogen affects your liver’s production of clotting factors. When you take ethinyl estradiol, your body makes more of proteins like factor VII, VIII, IX, and X. These help your blood clot normally when you cut yourself-but too much can lead to clots forming where they shouldn’t, like in your legs or lungs.
Desogestrel itself doesn’t cause clots, but when paired with estrogen, it’s part of a combination that increases clotting risk slightly compared to non-hormonal methods. Studies show that women using combination pills like this have about a 3 to 9 times higher risk of venous thromboembolism (VTE) than women not using hormonal contraception. That sounds scary, but let’s put it in perspective: out of 10,000 women using this pill for a year, about 3 to 9 will develop a blood clot. For women not using hormonal birth control, that number is about 1 in 10,000.
Who’s at Higher Risk?
Not everyone has the same risk. Some factors make blood clots more likely when you’re on desogestrel-ethinyl estradiol:
- Age over 35 - Risk increases steadily after 35, especially if you smoke.
- Smoking - Smoking while on estrogen-containing pills is one of the biggest risk multipliers. If you’re over 35 and smoke, this pill is generally not recommended.
- Obesity - A BMI over 30 doubles the baseline risk.
- Personal or family history of blood clots - If you or a close relative had a clot before age 45, especially without trauma, that’s a red flag.
- Genetic clotting disorders - Conditions like Factor V Leiden or prothrombin gene mutation can make you 5 to 10 times more likely to clot.
- Recent surgery or long immobility - Being stuck in bed or on a long flight increases risk temporarily.
If any of these apply to you, talk to your doctor before starting. There are progestin-only pills, IUDs, or implants that don’t carry this risk and may be safer for you.
Signs of a Blood Clot You Can’t Ignore
Most clots from birth control happen in the deep veins of the legs (deep vein thrombosis) or travel to the lungs (pulmonary embolism). Here’s what to watch for:
- Sudden swelling, warmth, or redness in one leg
- Pain in the calf or thigh that doesn’t go away with rest
- Shortness of breath, especially when lying down or with minimal activity
- Chest pain that gets worse when you breathe deeply
- Rapid heartbeat, dizziness, or fainting
- Coughing up blood
If you feel any of these, stop taking the pill and seek emergency care immediately. Don’t wait. Early treatment saves lives.
How the Risk Compares to Other Birth Control Methods
Not all birth control is the same when it comes to clotting risk. Here’s how desogestrel-ethinyl estradiol stacks up:
| Method | Estimated Risk |
|---|---|
| Not using hormonal birth control | 1 |
| Progestin-only pill (mini-pill) | 1-2 |
| Desogestrel-ethinyl estradiol | 3-9 |
| Levonorgestrel-ethinyl estradiol (older pill) | 5-7 |
| Birth control patch (Xulane) | 6-12 |
| Vaginal ring (NuvaRing) | 6-12 |
| Pregnancy | 29 |
Notice something? Pregnancy carries a higher risk than any birth control pill. That’s important context. The real question isn’t just whether the pill is risky-it’s whether it’s riskier than not using it.
What You Can Do to Lower Your Risk
If you’re on desogestrel-ethinyl estradiol and want to stay safe, here’s what works:
- Don’t smoke - Quitting is the single most effective thing you can do to reduce clot risk.
- Maintain a healthy weight - Even losing 5-10% of body weight can lower risk significantly.
- Stay active - Walk regularly, especially after surgery or long flights. Avoid sitting for hours.
- Know your family history - Ask relatives if anyone had unexplained clots before 50.
- Get tested if you’re high-risk - If you have a strong family history, ask your doctor about genetic clotting tests.
- Don’t skip checkups - Annual visits help catch changes in blood pressure, cholesterol, or signs of clotting.
What Happens If You Stop Taking It?
Once you stop the pill, your clotting risk drops back to normal within a few weeks. The extra clotting factors your liver made while on estrogen disappear quickly. That’s why doctors often recommend switching to a non-estrogen method if you’re at higher risk.
Many women switch to progestin-only options like the implant (Nexplanon), IUD (Mirena, Kyleena), or the mini-pill. These don’t raise clotting risk at all. Others choose non-hormonal methods like copper IUDs or condoms. The right choice depends on your health, preferences, and lifestyle.
When to Talk to Your Doctor
You don’t need to panic-but you do need to be informed. Schedule a conversation if:
- You’re over 35 and smoke
- You’ve had a blood clot before
- A close family member had a clot under age 45
- You’re planning surgery or a long flight
- You’ve noticed unexplained leg swelling or shortness of breath
- You’re thinking about switching birth control
Your doctor can help you weigh the benefits of clear skin, lighter periods, and reliable birth control against your personal risk profile. There’s no one-size-fits-all answer. The goal is to find the safest, most effective option for you.
Bottom Line
Desogestrel-ethinyl estradiol is a safe and effective birth control pill for most healthy women under 35 who don’t smoke. But it’s not risk-free. Blood clots are rare, but they’re serious. Knowing your personal risk factors, recognizing the warning signs, and talking to your doctor can keep you safe. You don’t have to choose between control over your body and your health-you just need the right information to make the call.
Does desogestrel-ethinyl estradiol cause blood clots?
Yes, it can increase the risk slightly because of the estrogen component. But the absolute risk is low-about 3 to 9 cases per 10,000 women per year. That’s higher than not using hormonal birth control, but lower than the risk during pregnancy.
Is it safe to take this pill if I’m over 35?
It depends. If you don’t smoke and have no other risk factors like obesity or a clotting disorder, it may still be safe. But many doctors recommend switching to a progestin-only method after 35, especially if you smoke. Smoking after 35 while on estrogen significantly raises your risk of stroke and clots.
What are the safest birth control options if I’m at risk for blood clots?
Progestin-only methods are safest: the implant (Nexplanon), hormonal IUDs (Mirena, Kyleena), or the mini-pill. Non-hormonal options include the copper IUD, condoms, or diaphragms. These carry no increased clotting risk.
How long does it take for clotting risk to go down after stopping the pill?
Your body clears the extra clotting factors within 2 to 4 weeks after stopping. The risk returns to baseline levels for non-users within a month. That’s why doctors often advise switching methods if you’re at high risk.
Can I take this pill if I have a family history of blood clots?
It’s not automatically off-limits, but it needs careful review. If a close relative had a clot before age 45 without trauma, your doctor may recommend genetic testing for clotting disorders like Factor V Leiden. If you test positive, you should avoid estrogen-containing pills entirely.
Comments (8)
Koltin Hammer
Look, I get it-people freak out about blood clots like it’s some hidden horror movie plot. But honestly? Pregnancy is way scarier. I had my wife on this pill for years, and the only thing that changed was her skin cleared up and she stopped screaming at me during PMS. The risk? Tiny. Like, ‘you’re more likely to get hit by lightning while winning the lottery’ tiny. And yeah, if you smoke or are obese or have a family history of clots, sure, talk to your doctor. But for most of us? This pill is just a tool. Not a death sentence.
Phil Best
Let me just say this: if your doctor handed you this pill without asking if you smoke, they’re either lazy or trying to make quota. I’ve seen too many women get handed a prescription like it’s a free sample of gum. ‘Here, take this, it’ll fix your acne and your mood swings.’ Meanwhile, your blood is turning into Jell-O. Stop normalizing this. If you’re over 30 and still puffing on cigarettes? You’re not ‘being brave’-you’re playing Russian roulette with your lungs and your veins.
kanishetti anusha
I switched to the copper IUD after reading this. No hormones, no clotting risk, and honestly? My periods are heavier but I feel more in control. I wish someone had told me earlier that non-hormonal options exist that don’t mess with your body’s chemistry. It’s not about fear-it’s about having real choices. You don’t have to accept risk just because it’s ‘common.’
Connor Moizer
Why are we even debating this? If you’re scared of blood clots, don’t take estrogen. Simple. Stop acting like this is some deep philosophical dilemma. Your body isn’t a mystery novel. If you have a family history? Get tested. If you smoke? Quit. If you’re obese? Move your ass. Stop blaming the pill. Blame the lifestyle choices you refuse to change. This isn’t rocket science-it’s basic health literacy.
roy bradfield
They don’t want you to know this, but the pharmaceutical companies know exactly how dangerous estrogen is. They’ve been burying the data for decades. That ‘3 to 9 per 10,000’ number? It’s a lie. They only count clots that happen within the first year. What about the woman who gets a pulmonary embolism at year 5? They ignore her. And don’t get me started on how they market this as ‘safe for acne’-like your face is worth a stroke. The real agenda? Profit. Not your health.
Eric Gregorich
Let’s be real for a second. We live in a world where we’re terrified of a 0.09% chance of a blood clot but will happily drive 60 miles an hour in a car with zero airbags. We’re obsessed with quantifying risk while ignoring the bigger picture. The pill gives women autonomy. It lets us plan our lives. It gives us the freedom to say ‘not today’ to motherhood. And yes, there’s risk. But so is walking down the street. So is breathing polluted air. So is eating processed food. The question isn’t whether it’s risky-it’s whether the trade-off is worth it. For me? Absolutely. I’ve had this pill for 7 years. My skin glows. My moods are stable. And I’ve never once felt a clot forming. That’s not luck-that’s informed choice.
And for everyone screaming about ‘natural alternatives’-have you tried a copper IUD? It’s like having a tiny metal dragon living inside you that hates your period. I tried it. I bled for three months straight. I cried in the shower. I almost moved to a monastery. The pill? It’s not perfect. But it’s predictable. And sometimes, predictability is the most radical form of self-care.
Also, let’s stop pretending that ‘progestin-only’ is some magical safe zone. I had a friend on the mini-pill who got a clot anyway. Turns out, it’s not just estrogen. It’s biology. It’s genetics. It’s your liver. It’s your lifestyle. And yes, sometimes, even the ‘safe’ options aren’t safe. So don’t vilify the pill. Educate yourself. Know your body. And then choose. Not out of fear. Out of knowledge.
And if you’re going to tell someone to ‘just quit smoking’-try doing it yourself first. It’s not a moral failing. It’s addiction. And addiction doesn’t care how smart you are. So cut people some slack. We’re all just trying to survive in a world that tells us every choice is life-or-death.
Bottom line: the pill isn’t the enemy. Ignorance is.
Willie Randle
It’s important to clarify that the increased risk of venous thromboembolism associated with desogestrel-ethinyl estradiol is statistically significant but clinically small. The absolute risk remains lower than that of pregnancy, which is a critical point often overlooked in public discourse. Additionally, newer formulations with lower estrogen doses have reduced this risk further. Genetic testing for thrombophilia, such as Factor V Leiden, is recommended only in cases of strong family history or personal history of unprovoked clotting. Routine screening in asymptomatic individuals is not supported by current guidelines. Lifestyle modifications-including smoking cessation, weight management, and physical activity-are universally beneficial and should be prioritized regardless of contraceptive choice. Always consult with a healthcare provider to individualize risk assessment.
Parv Trivedi
I come from India, where many women still don’t know about birth control options. I’m glad this post exists. My sister took this pill for acne, and she didn’t know about the clot risk. She got scared when she saw a swollen leg and stopped cold turkey-no doctor, no backup plan. That’s why education matters. Not fear. Not hype. Just clear, calm facts. We need more posts like this in local languages. Not just for the West. For everyone.