The risk in being risk-free

Doctors weigh potential side effects against advantages when choosing treatments

Date published: 8/21/2005

A MORNING NEWS program recently reported that a young woman, 18 years old I believe, who had died from a blood clot to her lungs while on the birth-control patch.

News of an otherwise healthy 18-year-old dying is very sad. But as a physician, in addition to sadness, my thoughts went something like, "Oh no, there are millions of women on the patch, and this is going to scare them to death."

The report went on to say that the AP had done a study and found that the rate of blood clots, medically referred to as deep vein thrombosis or DVTs, was higher among patch users than birth-control pill users.

Now, I was just waking up and my brain was still a little fuzzy, but, even in that state, something seemed wrong with that statement.

"Did they just say the AP?" I asked myself. "Doesn't that stand for The Associated Press?" And, most important, "When did The Associated Press start conducting medical studies?"

Fortunately, the next person on the screen was Dr. Tim Johnson, medical editor for ABC News, who disputed that the percentage of DVT cases for patch users is higher than for pill users. Johnson went on to make another important point--that the risks of pregnancy far outweigh the risks of any form of contraception.

I was happy that they brought Johnson on to clear up the confusion, but I was left thinking that it must be a slow news day.

We've known for ages that hormonal contraceptives increase the DVT risk. This is nothing new. The death of an otherwise healthy young woman because of a contraceptive is undeniabl tragic. But is it national news? Is it justified to scare the millions of women on the patch because of one death?

I haven't encountered a drug yet without potential side effects. And how do we know that any given drug has a particular side effect? Because someone, somewhere, experienced the side effect while on the drug. More correctly, multiple someones experienced the side effect.

The possibility of side effects, even deadly ones, is not just theoretical. They had to have happened to someone in order to become known side effects.

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Date published: 8/21/2005