Although the absolute risk of VTE may be small and even debatable among medical professionals at this time, there are steps you can take now to reduce your exposure if you are concerned:
Talk to your doctor. If your birth control pill contains drospirenone, the FDA advises that you continue to use it unless told otherwise by your healthcare provider. If you're considering using a drospirenone-containing pill, your doctor should weigh its risks and benefits in light of your personal risk for developing blood clots. Because you may use an oral contraceptive for several decades, your doctor should reassess your risk for VTE periodically.
Address your risk factors. The risk of a blood clot with combination birth control pills is highest during the first year of use especially in the first three months and when you restart the pill after a break of four weeks or longer. But the more risk factors you have, the greater your risk, so you should quit smoking no woman should take any combination birth control pill and smoke. And try to lose excess weight. Other triggers for VTE include being obese, recent pelvic or abdominal surgery or recent trauma to or fractures of the legs that lead to relative immobility, clotting disorders, chronic heart failure, frequent, lengthy airplane or car trips, and diabetes If you're planning surgery, ask your doctor about precautions including low-dose blood-thinning drugs and compression devices to keep blood flowing in the legs.
Stay active. Regular exercise such as walking improves circulation and reduces the risk of VTE. Move your legs often if you have to sit or lie down for an extended period of time. On long airplane trips, get up and walk every hour or so; if you can't, flex your calf and thigh muscles, and raise your toes 10 to15 times each hour to prevent blood from pooling in your legs. In addition, avoid alcohol and drink plenty of fluids, as dehydration makes blood more likely to thicken and clot.
Avoid the pill immediately after childbirth. The risk of VTE escalates in pregnant and postpartum women. Don't use combined hormonal contraceptives if you think you might be pregnant or during the first 21 days after delivery. Women who don't have risk factors for VTE can generally initiate use within 21 to 42 days postpartum, but those who have risk factors including recent cesarean delivery should wait at least 42 days. Alternatives for postpartum women include progestin-only contraceptives, IUDs and condoms
Know the symptoms of VTE. Seek medical attention immediately if you have swelling, pain, warmth, redness or discoloration of one leg, swollen-looking veins in the leg, or pain or tenderness in the calf muscle or groin. Symptoms of a clot in the lung include sudden shortness of breath, sharp chest pain, coughing up blood, and less commonly, dizziness, back pain or wheezing.
Monitor your potassium level. Drospirenone may increase serum potassium levels too much and for that reason should not be used by women with kidney disease. If you're on another medication that may increase potassium, you should have a blood test to check your level during the first month of taking a drospirenone-containing pill. Tell your doctor what medications you use, especially ibuprofen, naproxen, potassium-sparing diuretics, potassium supplements, and and certain blood-pressure drugs such as angiotensin receptor blockers (ARBs) and ACE inhibitors.
Don't use any type of hormonal contraceptive if: you have a strong family history (first-degree relative) of VTE or a personal history of blood clots, heart attack, stroke or breast cancer; or if you smoke more than 15 cigarettes a day or are over age 35 and smoke. Instead, consider methods such as the diaphragm, sponge, condom, or a non-hormonal IUD.