Medical disclaimer: This is general information, not medical advice. It does not replace an exam or a conversation with a licensed clinician. Rules and registries change; confirm details with official sources before you decide.
Short answer: maybe, and it's not a decision to make alone. Estrogen-containing hormones can add to the clot risk that surgery and long flights already carry, so your surgeon and the clinician who prescribes your hormones should decide together whether to pause, switch or continue, and for how long.
This guide explains how hormones fit into the bigger clot-risk picture, how different methods are generally viewed, and what to sort out before you book flights. For the flight itself, see our separate guide to long-haul travel and clots.
Why hormones matter: stacked clot risk
Venous thromboembolism (VTE) means a blood clot in a vein, usually in the leg (deep vein thrombosis), that can travel to the lungs (pulmonary embolism). Clot risk is rarely about one thing. It builds up from several factors at the same time:
- The surgery itself: tissue injury and time under anesthesia make blood more likely to clot.
- Immobility: lying in bed or sitting for long stretches during recovery slows blood flow in the legs.
- Long-haul travel: hours in a seat, sometimes soon after surgery.
- Hormones: estrogen in particular is known to increase clotting tendency.
- Your own history: a previous clot, a family history, a known clotting disorder, smoking, higher body weight, or older age.
Surgeons usually assess this formally with a risk score and then choose prevention: walking early, compression, and sometimes a blood thinner. Your hormones belong in that assessment. The goal isn't to make you anxious about one pill; it's to make sure nothing in the stack is invisible to the people planning your care.
List every hormone you take on your intake forms, including patches, rings, injections, implants, gels, IUDs and anything bought without a prescription. "I'm on birth control" isn't enough detail for a risk assessment.
Birth control: not all methods are the same
Contraceptives fall into broad groups that are generally treated differently before surgery. The exact advice depends on your product, dose and health history, so use this table to frame the conversation, not to make the call.
| Method type | Examples | General view | Ask your prescriber |
|---|---|---|---|
| Estrogen-containing (combined) | Combined pill, patch, vaginal ring | Most often raised as a concern before major surgery with reduced mobility | Should I pause, and if so when and when do I restart? What backup should I use? |
| Progestin-only | Progestin-only pill, implant, injection | Generally viewed as lower clot concern than estrogen methods, but still worth listing | Is it fine to continue through surgery and travel? |
| Hormonal IUD | Levonorgestrel IUD | Usually left in place; very low systemic hormone dose | Any reason to change anything? |
| Copper IUD | Non-hormonal IUD | No hormone involved | Just list it so the team knows |
Some guidelines suggest stopping estrogen-containing contraception several weeks before major elective surgery that involves prolonged immobility, and restarting after you're fully mobile again. The exact window, and whether it applies to your procedure, is something your surgeon and prescriber will advise. Bring the question early, because a pause that's needed may need to start before you'd normally think about packing.
Ask the question by message as soon as you have a surgery date: "I take [product and dose]. Do you want me to pause or switch it before surgery and the flight home, and when should I restart?" Keep the written answer.
Menopausal hormone therapy
Menopausal hormone therapy (often called HRT or MHT) comes in different forms, and the route can matter. Oral estrogen is processed by the liver and is generally discussed as having more effect on clotting than estrogen delivered through the skin (patches, gels, sprays). Vaginal estrogen at low doses is usually considered to have minimal effect on the whole body.
Whether to pause HRT before surgery isn't a one-size answer. Stopping can bring back symptoms such as hot flashes and poor sleep right when you need rest to recover, and some clinicians prefer to continue it while strengthening other clot prevention. Others may suggest a pause or a switch in route. That trade-off is exactly why it should be discussed between your surgeon and the clinician who manages your HRT.
- Name, dose and route of each hormone (oral, patch, gel, vaginal, other)
- Whether you take a progestogen too, and in what form
- Any past clot, stroke, or clotting disorder in you or close family
- What your HRT prescriber recommends, in writing
Gender-affirming hormone therapy
If you take estrogen, testosterone, anti-androgens or blockers as part of gender-affirming care, you deserve the same individual, evidence-based planning as anyone else, and a surgical team that treats your hormones as routine medical information.
- Estrogen-based therapy: estrogen's effect on clotting is part of the same risk conversation as above. Route and dose matter, and practice varies on whether to pause, lower the dose or continue with stronger clot prevention.
- Testosterone: can raise red blood cell levels (hematocrit), which your team may want to see on pre-op bloodwork.
- Stopping isn't free: pausing hormones can affect mood, energy and wellbeing during recovery, which is already a vulnerable time far from home. That's part of the decision, not a side issue.
Ask your hormone prescriber to talk with your surgeon directly, or to put a recommendation in writing you can forward. If a clinic is dismissive or uncomfortable discussing your hormones, treat it as a signal about how the rest of your care may go.
Pregnancy testing and backup contraception
If there's any chance you could be pregnant, expect a pregnancy test before elective surgery. This is standard practice, not a judgment: anesthesia, some medications and elective surgery itself are reconsidered or postponed during pregnancy. The test is often done shortly before the procedure; ask your surgeon when.
If a contraceptive method is paused, you'll need a plan for the gap:
- Agree the datesAsk your prescriber exactly when to stop and when to restart, based on your surgery and travel dates.
- Choose a backupAsk which non-estrogen option fits you during the pause, such as condoms or a progestin-only method.
- Check medication interactionsAsk whether any antibiotic or other drug you'll be given could affect your contraception.
- Pack what you needBring the backup method with you; don't assume you'll find your preferred brand locally.
How to make the decision with your team
The safest outcome usually comes from getting your surgeon and your prescriber on the same page. Your surgeon knows the procedure, its length and expected mobility; your prescriber knows your hormones and why you take them.
- Send both doctors the same summary: procedure, surgery date, flight dates and flight length
- List every hormone with product name, dose and route
- Mention any personal or family history of clots or clotting disorders
- Ask the surgeon how clot risk will be assessed and which prevention is planned
- Ask the prescriber whether to continue, pause or switch, and the restart date
- Keep both answers in writing and bring copies to Colombia
Sudden shortness of breath, chest pain, coughing blood, or one swollen, painful or warm calf needs emergency care now. In Colombia call 123; in the US call 911.
Frequently asked questions
Do I have to stop my birth control pill before surgery abroad?
Not necessarily. It depends on whether your method contains estrogen, the type and length of surgery, your other risk factors and your travel. Your surgeon and prescriber should decide together, and you shouldn't stop on your own.
Is the progestin-only pill or an IUD a problem before surgery?
Progestin-only methods and IUDs are generally viewed as a lower clot concern than estrogen-containing methods, and IUDs are usually left in place. Still list them on your forms so the team has the full picture.
Should I stop HRT before cosmetic surgery?
Practice varies. Route matters (oral estrogen is generally discussed as having more effect on clotting than patches or gels), and stopping can bring symptoms back during recovery. Ask your surgeon and HRT prescriber to agree on a plan.
I take gender-affirming hormones. Will I have to stop them?
Not automatically. Your surgeon and hormone prescriber should weigh your clot risk against the effects of stopping, and may adjust dose, route or clot prevention instead. A respectful team will discuss it with you as routine medical planning.
Why do I need a pregnancy test if I'm on birth control?
No method is perfect, and pausing a method creates a gap. Elective surgery and anesthesia are usually reconsidered during pregnancy, so a test before surgery is standard practice for anyone who could be pregnant.