Posted on August 11, 2020 by Dr. Noel R. Williams

Humans...

Oral contraceptives, oral estrogen or the nuvaring contraceptive device all mildly increase the risk of thrombotic events. These risks increase potentially with smoking and/or obesity.

We are talking only about the above!
*****ORAL Estrogen or Nuvaring Birth Control Ring ***

Not anything else.

Topical Estrogens.... gels, creams, patches, troches, pellets and injections, rings for menopause, vaginal tablets or creams.................. DO NOT!!!!

Natural Progesterone or Progestin only Birth Control Pills DO NOT!!!!

IUDs of any type DO NOT!!

As more data accumulates about COVID-19 additional potential disease events become apparent.

The one that is germane relative to these forms of estrogen is the elevation in risk of micro-embolic events in COVID-19 patients.

A micro embolic event is when a very small clot forms in a blood vessel and then breaks off, travels, then occludes or blocks the end of a smaller blood vessel. This leads to a mini infarction/stroke of the tissue the blood vessel fed.

In older pts with COVID19 up to 70-80% with only mild symptoms; cold or flu stuff are having these occur. Unfortunately these micro-emboli are occurring in younger pts too.

If you are on an oral estrogen or nuvaring please consider notifying your Ob/Gyn or other provider if you get COVID19 to discuss this potential issue. Make them aware of the mild increased clot potential with your hormone therapy and the recent concerns with COVID infection for elevated thrombotic events. They will be able to determine any care plan changes if even warranted.

COVID19 is turning into a complex medical management nightmare across all medical specialties.

All the best!

Noel Williams

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