Does a patient with Behcet's disease taking Camrese Lo (levonorgestrel and ethinyl estradiol) birth control pills have an increased risk of developing blood clots?

Increased Blood Clot Risk with Camrese Lo in Behçet's Disease

Yes, taking Camrese Lo (a combined estrogen-progestin contraceptive) with Behçet's disease significantly increases your risk of blood clots and should be avoided. Behçet's disease is specifically identified as a condition associated with cerebral venous thrombosis, and combined oral contraceptives dramatically amplify this baseline thrombotic risk 1.

Why This Combination Is Dangerous

Combined hormonal contraceptives like Camrese Lo are contraindicated in Behçet's disease because:

• Behçet's disease itself causes vasculitis and creates a prothrombotic state, predisposing patients to venous thrombosis 1
• The estrogen component in Camrese Lo decreases natural anticoagulants (antithrombin III and protein S) while increasing coagulation factors, creating a procoagulant environment 2, 3
• Combined oral contraceptives increase the risk of cerebral venous thrombosis by 15.9-fold in healthy women 1
• When underlying thrombotic conditions exist (like Behçet's disease), this risk compounds dramatically—similar to how women with Factor V Leiden mutation using OCPs show a 30-fold increased odds of cerebral venous thrombosis 2

The Magnitude of Risk

The FDA drug label for ethinyl estradiol explicitly warns that the risk of thromboembolic disease increases 3-11 fold with combined oral contraceptives, with even higher risks in women with predisposing conditions 3. Behçet's disease qualifies as such a predisposing condition 1.

Safe Contraceptive Alternatives

You should switch to progestin-only or non-hormonal contraceptives immediately:

First-Line Recommendations:

• Levonorgestrel IUD: Highest efficacy (<1% failure rate) with no increased thrombotic risk (RR 0.61,95% CI 0.24-1.53) 1, 2, 4
• Copper IUD: Completely hormone-free with equivalent contraceptive efficacy and no thrombotic risk 1, 4

Alternative Options:

• Progestin-only pills: Safe thrombotic profile (RR 0.90,95% CI 0.57-1.45) but require strict daily adherence 1, 2
• Etonogestrel implant: Does not induce prothrombotic state and highly effective 2

Contraceptives to Avoid:

• All combined estrogen-progestin contraceptives (pills, patches, vaginal rings) are absolutely contraindicated 1, 3
• Transdermal patches: Provide even higher estrogen exposure than oral formulations 1, 2
• Depot medroxyprogesterone acetate (DMPA/Depo-Provera): Should be avoided due to increased VTE risk (RR 2.67) similar to combined OCPs 1, 2

Critical Action Steps

1. Stop Camrese Lo immediately and contact your prescribing physician 3
2. Use barrier contraception (condoms) until you establish an alternative method 1
3. Schedule an appointment to discuss IUD placement or progestin-only alternatives 1, 4
4. Inform all healthcare providers about your Behçet's disease diagnosis when discussing contraception 1

Common Pitfall to Avoid

Do not assume that lower-dose estrogen formulations are safe—even low-dose combined contraceptives (like Camrese Lo) maintain significant thrombotic risk in patients with underlying prothrombotic conditions 3, 5. The presence of Behçet's disease changes the risk-benefit calculation entirely, making any estrogen-containing contraceptive unacceptable 1.