Factor V and contraceptives

Patient

Q: We have just found out that my wife has Factor 5 and we're now trying to find out what kinds of birth control options there are. We susspected she had Factor 5 since several in her family have it and she has VERY irregular periods. We finnaly sved enough to have the test done to find out for sure and it came back positive. We're financially unable to aford to go to the Dr.s for further testing and advise so I'm hoping you can give us some. Thank you very much for reading my message.

Doctor

A:   I understand how concerned you are about your wifes recent diagnosis of Factor V Leiden. As you and your wife may know already, this is not a disease; it is the presence of a particular gene that is passed on from your parents. Factor V Leiden is a variant of the protein Factor V (5) which is needed for blood clotting. People who have a Factor V deficiency are more likely to bleed badly while people with Factor V Leiden have blood that has an increased tendency to clot. People carrying the Factor V Leiden gene have a five times greater risk of developing a blood clot (thrombosis) than the rest of the population. However, many people with the gene will never suffer from blood clots.Since your wife has the presence of Factor V she has an increased ability to clot her blood, unfortunately she might need to be followed up by her Primary care physician from time to time. About the contraceptives methods, oral contraceptives have increased tendency to produce Deep Vein Thrombosis and would not be recommended for her. Certainly a more detailed history and examinations might be needed but she would probably benefit more from barrier methods such as male or female condoms. In the meantime I would suggest her to avoid standing or sitting in the same position for long periods of time, When travelling long distances it is important to exercise regularly since the blood must not stand still, avoid smoking and lose weight and most importantly consult your doctor before becoming pregnant as this can also increase the risk of thrombosis. I wish you the best.

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