I tested as 6x the average risk of developing DVT at 23andme (average risk is about 10%). I don't see pulmonary embolism listed in my report.

I'm "middle-aged" but so far haven't had this happen, despite some extra risk factors - I've been on the Pill for ~20 years and I do sit a lot (I'm a software developer). I'm not a frequent flyer, but I have flown many times and never had a problem. I naturally shift position pretty often when sitting, so I'm not sure if this helps. Or maybe whatever gene is responsible is just there, and hasn't turned on yet. How to stop it from turning on? I don't think anyone knows.

I was surprised to see that OP got a DVT when he walks 1-3 miles every day. That seems far better than what most people do (I try to walk about 2-3 mi per day). I don't see how switching to running could be more preventive.

The F5, F2, and ABO risk variants are for developing VTEs, a DVT is a type of VTE, and a PE is a DVT that makes it to the lungs. If you have one or more of the variants, it's already "on."

I'm not a physician and don't even play one on the internet, but if I were a mid-aged woman I would consider an IUD (with or without hormones) as an effective alternative to the pill. Even hormonal IUDs have vastly lower dosages than the pill.

Like the "sitting epidemic," VTEs care more about sustained periods of immobility, regardless of fitness levels. Paradoxically, even though obesity is its own risk factor, seriously atheletic types are highly vulnerable too: higher fitness -> lower heartrate -> slower circulation -> clotting. Sports teams are known to wear compression stockings on flights to combat the issue.

If you're 6x, I'd highly recommend reading about lifestyle changes. Best wishes!

I have the F5 and F2, but not ABO.

but if I were a mid-aged woman I would consider an IUD (with or without hormones) as an effective alternative to the pill

I take the pill as a treatment for severe dysmenorrhea which did not respond to any other treatments. To my knowledge, regular IUDs do not help with that. When I saw the 23andme results years ago, I didn't know there were any options beside the Pill for dysmenorrhea. I had to make the choice between continuing to hold down a regular job, and accepting the risk. I probably would have been wise to bring up the test results with my doctors, but I have low expectations of them (revolving door treatment). So I just made the decision on my own.

After hunting around, I see there are IUDs that come with hormones that have been known to help with dysmenorrhea: http://www.uptodate.com/contents/long-term-methods-of-birth-... It's something my doctors never mentioned to me.

I'm nearing the time when I should stop taking BCP, so I don't see the point in experimenting with other options, given I've survived till now (IUDs are usually planned to be used for 1+ years). I did find that I had to switch between a few different types of pills before I found one that had the best effect, and doing this for an IUD would be quite a production, if it even worked.

It's interesting to me that I've never had a doctor mention to me risks for DVT at all. Doctors ask for a family history (no history of blood clots in my family). Based on that, I guess they have assumed I do not have a high risk for blood clots.

Here's a relevant quote: https://bedsider.org/features/168-risky-business-2-migraines... "Some types of genetic testing can reveal a predisposition for blood clots or stroke (though it’s not clear if a genetic test that shows this predisposition actually predicts that the condition will develop)."

higher fitness -> lower heartrate -> slower circulation -> clotting

Interestingly, Serena Williams was reported to have DVT (she had a PE although I haven't found a source that said it was definitely from DVT). She had recently had an injury to a foot which required surgery and 18 stitches, and also it happened on a flight...

I am reasonably athletic, but my resting heart rate is about 80 bpm. Maybe that's something that's been helping me.

Aside from genetics, the risk factors for DVT are reportedly: 1) Smoking 2) Birth control pills 3) Hormone replacement therapy with estrogen and progesterone 4) Recent surgery, especially on the legs or belly 5) A long hospital stay involving bed rest 6) Some cancers 7) Pregnancy and childbirth, particularly with C-section 8) Age over 70 9) Obesity http://www.webmd.com/lung/news/20110302/serena-williams-pulm...

Notice they don't even mention travel at webmd....

So if I get off the BCP, avoid surgery, and die before 70, maybe I'll be fine ;)

I'm rooting for ya! (and me)