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Common questions
In this section common questions about thrombosis are answered by experts in the field.

 General questions

• Q: Can VTE (or its treatment) cause a low sperm count?
  A: No–we are not aware of any evidence for a link between a low sperm count and either VTE or its treatment. If they occur together, it is likely to be just a coincidence: a certain proportion of men have low sperm counts, and a certain proportion of men will develop VTE and be treated for it, and there will always be some overlap. You should consult your physician, who may wish to refer you to a urologist or other specialist in male infertility.
  
  
• Q: Is it safe to breast-feed while taking low-molecular-weight heparin?
  A: You should exercise caution, and certainly discuss this with your treating physician before beginning to breast-feed. One small study of dalteparin found that it could be detected in the breast milk of some women, but in very low concentrations. The researchers concluded that it was "highly unlikely" that this would have any clinically relevant effect on the infant. Overall, however, relatively little information is available.
   
• Q: What is the difference between deep vein thrombosis (DVT) and pulmonary embolism (PE)?
  A:  DVT is the formation of a blood clot (thrombus) within one of the large, deep veins of the upper or lower limbs, usually in the deep veins of the calf, thigh, knee or pelvis. DVT itself is not life-threatening.
  
  PE is a serious complication of DVT where the blood clot can break into smaller pieces, float in the blood and become lodged in the blood vessels supplying the lungs. If left untreated, PE can lead to a heart attack or sudden death.
  
  
• Q: Who gets them?
  A: DVT and PE can affect sick, hospitalized patients, patients undergoing major surgery and patients with serious medical conditions (e.g. stroke, heart disease or cancer). However, people without other medical problems can also be affected, such as the elderly and pregnant women.
  

• Q: The risk of deep-vein thrombosis (DVT) or pulmonary embolism (PE) is increased with oral contraceptives. Is it safe for all women to use the contraceptive pill?
  A: Despite there being a slightly higher risk of developing blood clots for women taking the pill, blood clots are very rare, and the overall risk remains low. Women who take the pill are at greater risk of DVT if they are obese and if they smoke.
  
  
• Q: What can be done to reduce this risk?
  A: If you are a smoker and/or overweight, you can greatly reduce your risk by stopping smoking and losing weight. Some oral contraceptives (progesterone-only pills) do not contain estrogen, which may reduce your risk of developing a blood clot.
  
  
• Q: Should I stop taking it?
  A: You should not stop taking your oral contraceptive without first consulting your physician.
  
  
• Q: Which women should not take it?
  A: Some women are at greater risk of having a blood clot due to additional risk factors such as a blood-clotting disorder, previous blood clot, or close family member who has had a blood clot. If you have any of these risk factors your physician may suggest that you use an alternative form of contraception.

• Q: How do I know if I have got deep-vein thrombosis (DVT) or pulmonary embolism (PE) and how easy is it to recognize the symptoms?
  A: The signs or symptoms of DVT are difficult to detect and diagnose correctly. Many patients with DVT have no symptoms at all. A further problem is that many other conditions produce similar symptoms to those seen with DVT. Symptoms of DVT may include varicose veins, tenderness, pain, swelling, and redness in the affected limb. Other conditions that exhibit similar symptoms include skin infections in particular, and muscle strains. Your physician will have to conduct tests that examine the deep vein of your affected limb if he/she suspects you have DVT.
  
  Symptoms of PE may include shortness of breath, sharp chest pain that is worse during deep breathing, coughing up of blood and a rapid heart beat. Other conditions that exhibit similar symptoms include heart attack and pneumonia.
   
• Q: How does my physician diagnose these conditions?
  A: Your physician will have to conduct tests if he/she suspects you have PE. The tests for DVT and PE are described elsewhere in this website.

Prevention of thrombosis

• Q: I am going on a long flight soon, what should I do during the flight to prevent me getting thrombosis?
  A: The risk of deep-vein thrombosis (DVT) during long journeys can be reduced by not crossing your legs; periodically getting up and walking around (if possible); and performing leg exercises while seated, such as squeezing your calf muscles, pointing and flexing your feet and wiggling your toes. You should also make sure that you are not dehydrated, so avoid alcohol and drink plenty of water.

Treatment of thrombosis

• Q: How complicated is the treatment for thrombosis?
  A: When receiving treatment for thrombosis, you will be given a medication to thin your blood. For example, unfractionated heparin or low-molecular-weight heparin might be given for 5 days followed by oral anticoagulants. Some treatments are more complicated than others because they require different methods of administration (i.e. by mouth, injection or intravenous infusion), and also may need you to be monitored more closely, or receive treatment more frequently.
   
• Q: How do I know if it is working?
  A: It is likely that your physician will test your blood, sometimes at regular intervals, to make sure that the treatment is working and that you are receiving the correct dose of the medication.
  

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