Sarah had a heart attack when she was 23. Her doctors believe it was caused by the Pill.

Image: Sarah Brison/JustGiving.

In July this year, Sarah Brison suffered a heart attack that left her in a critical condition.

The UK nursery nurse and semi-professional soccer player, who was 23 at the time, awoke one morning in “unbearable” pain and the sensation that her body was shutting down.

“Everything went blurry. Then, within seconds, I lost my vision completely. I couldn’t feel my limbs, had no control over my body and I was sweating uncontrollably,” Brison, now 24, tells The Sun.

“It was like brain freeze except it was all over my chest, as if someone was pressing down on me with all of their weight.”

Although the symptoms clearly worried her, Brison assumed she was having a panic attack that didn’t require medical attention. She even apologised to the paramedics who arrived on the scene after her boyfriend Billy called for an ambulance. She thought she was wasting their time.

However, it’s likely that phone call saved her life. Brison had in fact suffered a heart attack; her blood pressure was dangerously low and her heartbeat was abnormal.

Hospital tests soon revealed she had clots on the vessels leading to her heart. It turned out Brison also had a hole between the two top chambers of her heart, through which a clot had managed to pass.

"I just kept asking the doctor how it could have happened ... Surely 23-year-olds didn't have heart attacks? I kept asking if I was going to die," she tells The Sun.

One consultant offered a possible cause: the contraceptive Pill. Brison had been using the contraceptive for seven years but had recently switched from a mini pill to the combined pill.

“I had heard about it being linked with an increased risk of blood clots so I asked my doctor if it was safe. But my GP told me it would be highly unlikely anything would happen," she recalls.

Like Brison, you've probably heard of the link between the Pill and blood clots — and read stories about women who have suffered fatal health complications as a result. However, it's very important to remember this risk is small. (Post continues after video.)

“Combined pills do increase the risk of blood clots in all women who use them, but that absolute risk is very, very small,” says Dr Deborah Bateson, Medical Director of Family Planning NSW.

Evidence suggests this risk is increased around two to three times in combined pill users compared to non users, with a baseline rate of ten women per 10,000 affected per year.

“For most women of reproductive age who are taking the Pill that risk is extremely low; in fact, much lower than the risk of blood clotting in pregnancy or immediately after delivery. There’s a risk of a spontaneous blood clot in all non-Pill users as well," Dr Bateson explains.

The risk of blood clotting among users of the combined pill is effected by the level of oestrogen in its formula. Since the Pill was introduced in Australia, this dose has been gradually reduced from its original higher levels.

Dr Bateson says the low-dose Pills available today are a very safe formulation, and despite reports to the contrary, research is yet to determine whether certain brands are associated with a higher clotting risk.

Although the risk of blood clots is low for most women who use oestrogen-based birth control, there are factors that can make them unsafe for some women. These factors include past experience with a blood clot, a strong family history of clots, or a mutation that increases susceptibility to developing one.

For this reason, it’s important for GPs to take a good family history before prescribing birth control; it’s rare that an existing risk factor won’t show up in a woman’s family previously.

Dr Bateson says there are a few other blood clot risk factors that make some people ineligible to use the combined pill or other oestrogen-based birth control methods.

A woman who is immobilised or very overweight would be ineligible, while smoking and age are also viewed as risk factors — doctors generally stop prescribing the Pill for women when they reach the age of 50. (Post continues after gallery.)

The good news is, there are several alternatives available for the small number of women who can’t use oestrogen contraceptives. There are progesteron-only methods, like the hormonal intrauterine device (IUD) and hormonal implant, or methods that contain no hormones at all, like the copper IUD.

If you’re concerned about the risk of blood clots, make an appointment to talk through your birth control options with a GP, or give the Family Planning Talkline (1300 658 886) a call, before taking any action independently.

“For those women who are choosing the Pill, it’s a very, very safe option indeed that’s been used for a long time. We’re certainly happy to prescribe the Pill for women when we’ve taken a good family history and we know they haven’t got those additional risk factors for blood clots," Dr Bateson says.

As for Sarah Brison, she is still having regular checkups and takes five types of medication a day, including blood thinners. She's been advised to stop taking the Pill. “Getting some normality back after the past few months has been surreal. Having a heart attack has changed my outlook on life. It’s made me see what’s important," she tells The Sun.

Do you use the Pill? Have you ever been advised not to for health reasons?