Shortness of breath (dyspnea) is an uncomfortable sensation that makes a person feel unable to take a full breath. While using hormonal birth control, this symptom is rare and not typical. However, when dyspnea occurs, it can signal a serious, life-threatening condition linked to the medication. This connection is rooted in how certain contraceptive hormones alter the body’s blood clotting mechanisms.
How Hormonal Birth Control Affects Blood Clot Risk
Hormonal contraceptives containing estrogen can affect the body’s balance of clotting factors. Estrogen increases the production of proteins that promote blood coagulation while reducing the activity of proteins that dissolve clots. This shift creates a state of hypercoagulability, meaning the blood is more likely to form a clot.
This increased clotting potential leads to venous thromboembolism (VTE), which involves the formation of blood clots in the veins. VTE often begins as a deep vein thrombosis (DVT), typically forming in a deep vein of the leg, thigh, or pelvis. If a DVT breaks loose, it can travel through the bloodstream to the lungs.
When a traveling clot lodges in a lung artery, it causes a pulmonary embolism (PE), blocking blood flow to lung tissue. A PE immediately reduces the lung’s ability to deliver oxygen to the blood. This sharp decrease in oxygen exchange is the direct cause of sudden, severe shortness of breath. The absolute risk is small, with 3 to 9 women out of every 10,000 using combined hormonal contraceptives developing VTE each year, compared to 1 to 5 women per 10,000 not using them.
Recognizing Serious Symptoms and Medical Emergencies
The shortness of breath associated with birth control use is a sign of a pulmonary embolism and requires immediate medical attention. This breathing difficulty is typically sudden, unexplained, and may feel like an inability to catch one’s breath even while at rest.
The breathlessness often occurs alongside other symptoms indicating a medical emergency. A sharp, stabbing chest pain is common, particularly when taking a deep breath, coughing, or bending over. A rapid or irregular heartbeat (tachycardia) may also be present.
Other signs can point to the presence of a DVT. These include pain, swelling, warmth, and redness in one leg, most often the calf or thigh. If these symptoms—especially sudden dyspnea, chest pain, or coughing up blood—are present, they signal a need for emergency medical care.
Risk Factors Based on Contraceptive Type and Personal Health
The risk of VTE is primarily linked to contraceptives that contain both estrogen and progestin, such as combined oral contraceptive pills, the transdermal patch, and the vaginal ring. The presence of estrogen is the component that drives the increase in clotting factors.
The risk level can also vary based on the specific type of progestin used in the combined pill formulation. Some newer progestins, such as drospirenone or desogestrel, are associated with a slightly higher VTE risk compared to older formulations containing levonorgestrel. Methods that contain only progestin—including the mini-pill, hormonal IUD, and contraceptive implant—do not carry the same increased risk of VTE.
Individual health conditions can significantly compound the baseline risk associated with combined hormonal methods. The risk of developing VTE is also highest during the first year of starting a combined hormonal contraceptive or after restarting the medication following a break of four weeks or more.
Personal Risk Factors
- Being over the age of 35, especially when combined with smoking.
- Having a body mass index (BMI) that indicates obesity.
- A personal or close family history of blood clots.
- Inherited clotting disorders, such as Factor V Leiden mutation.
Steps to Take If You Experience Breathing Difficulty
If you experience sudden, severe shortness of breath, call emergency services immediately. These symptoms suggest a pulmonary embolism and require immediate diagnostic tests and treatment to prevent life-threatening complications. Do not attempt to drive yourself to the hospital if you are experiencing acute symptoms.
For breathing difficulties that are mild, persistent, or confusing, contact your healthcare provider right away for an urgent consultation. Your doctor will assess your symptoms and determine if they are related to your birth control or another cause, such as asthma or anxiety. Never stop taking your prescribed hormonal contraceptive without first speaking with a medical professional.
Stopping the medication abruptly may disrupt your hormone balance and increase the risk of an unintended pregnancy. A healthcare provider can advise you on whether your current method is safe to continue or if you should switch to a non-estrogen option. They may recommend further testing to assess your blood clot risk factors before deciding on the safest course of action.