Why Are Young, Healthy Women Getting Blood Clots?

The news of stylist Annabel Tollman's death was met with shock and sadness on Friday morning. How could a young, healthy 36-year-old woman with a bright future die suddenly in her sleep-apparently of a blood clot?

By Michelle Ruiz

Clots are supposed to conjure up images of sedentary grandparents and compression socks-not energetic young women full of promise. But "the truth is that clots do happen to thin, active, normal women," Dr. Lauren Streicher, assistant clinical professor of obstetrics and gynecology at Northwestern University's Feinberg School of Medicine, told Cosmopolitan.com.

Sadly Tollman isn't the first young woman we've known to suffer a sudden blood clot, whether due to a genetic blood disorder, a pre-existing hormonal problem, or a rare, unlucky side effect mentioned in the fine print or in rushed tones at the end of birth control ads. Hours before learning of Tollman's death, Cosmopolitan.com published the July issue story of a 31-year-old mom of triplets who suffered a ministroke due to blood clots in her legs caused by a congenital heart defect.

Related: I'm Too Young...for a Stroke

Another woman, Rachel Humphrey, was 28 years old when she collapsed in the upstairs bathroom of her home in Sterling, Va. In the days leading up to the incident, doctors had misdiagnosed her heavy breathing as bronchitis. In fact, her lungs were riddled with blood clots and had cut off oxygen to her brain, causing her to suffer anoxia, an episode similar to a stroke. When she woke up from a 14-day medically-induced coma, doctors told Rachel that "it was absolutely birth control" that caused her clots, Humphrey recalled to Cosmopolitan.com.

More specifically, it was a lethal combination of Rachel's birth control, Ortho Tri-Cyclen, her polycystic ovarian syndrome (PCOS) and a genetic blood disorder Rachel never knew she had called Factor II, which causes a lack of an important blood-clotting protein. Rachel's PCOS causes a hormonal imbalance in her system-too much testosterone, not enough estrogen-which led her to go on birth control for five years to regulate her cycle. During that time, unbeknownst to Rachel, she became a ticking time bomb as the estrogen from her birth control fueled her already-higher risk of a clot.

Related: What's an IUD Again?

"When I was at the rehab center, a lady asked me what had happened to me and I didn't hesitate to tell her: 'I was taking birth control and almost died,'" Rachel said. "No one thinks twice-they just pop [birth control pills] and go on their merry way."

Now 35, Rachel's episode changed her life forever, leaving her with brain damage and memory loss that forced her to leave her job as a government contractor. She had to relearn to speak, walk, eat, and read. Because pregnancy increases the risk of clots, Rachel says she shouldn't have kids.

Had she known about her Factor II blood disorder, which is detectable via blood test, she says she never would have gone on birth control in the first place. But most gynecologists don't test for blood clotting disorders because they affect so few patients. (After Rachel's ordeal, her sister-in-law elected to pay out of pocket for a test.) While anyone on the pill has an increased risk of clots, "most people" who take birth control won't get them. Citing studies, Dr. Streicher reports that only between three and nine women in 10,000 on the pill will suffer a clot. Still, women like Rachel with hidden preexisting conditions are "special," scary cases.

Schuyler Williams, a 31-year-old account executive at the Wall Street Journal and a lifelong athlete and marathon runner, was 27 when she began to feel shortness of breath while simply walking down the street or climbing her apartment stairs in New York. For a week, she "saw stars" while just sitting at her desk or had "blackout moments" when she stood up.

"It became painful just to take a deep breath, like I'd swallowed chlorine," she told Cosmopolitan.com. "The pain just got progressively worse-through my thyroid, down my back and through my chest to the point where I thought I'd broken a rib somehow."

Friends convinced her to go to the ER, revealing three blood clots on her lungs-and a genetic blood mutation that fueled her clots. "They basically asked me: One, are you taking birth control? And two, have you been on a long flight or been sedentary for a long period of time?" Schuyler said. She only answered "yes" to the first question. She'd been on the pill for years, not knowing that her blood disorder put her at an increased risk for clots.

"We should be educating people that if you have a disposition of some sort, you should consider alternative birth control," she added. "It could be a matter of a very simple blood test." Schuyler says she'll never take birth control pills again, having switched to a completely hormone-free copper-based IUD.

Neither Schuyler nor Rachel knew about their genetic conditions, nor did their mothers, who are also predisposed to clots. For women now worrying about their own risk of clots, Dr. Streicher advises knowing the risks, including obesity, smoking, sedentary lifestyles and family history.

"Like BRCA or heart disease, talk to your family about this," Dr. Streicher advises. "It's vital to get all the information you can to protect yourself."

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