Contraception and IBD/Arthritis
There are lots of different options out there for women who want to prevent pregnancy. What many people (including some GPs) don’t understand is the effect that IBD can have on the way our bodies process these, sometimes resulting in them becoming completely useless at their intended job. I’m not medically trained but this post is based on the information I have been given and that I have researched over the years while looking for contraception for myself. I’m happy to share my knowledge and advice but remember, everyone’s bodies and experiences are different. Your doctor will be the best person to advise on what is right for you and your situation personally.
Being on Methotrexate for many years means preventing an unplanned pregnancy is extremely important to me. Methotrexate can cause birth defects and/or miscarriages and it is something I wouldn’t want to put myself, or a baby through. This means looking into good contraception has been high on the agenda while I have not been looking to have a baby. I’m going to share a list of contraception available and offer some information about each type. I will also explain the possible effects that IBD and Arthritis could cause to the usefulness of these methods.
CONDOMS
Probably the easiest method of contraception to get hold of, condoms not only prevent pregnancy but also many sexually transmitted diseases too. Great for more casual dalliances, sometimes a bit of a mood ruiner when you are in the throes of passion! A good option for anyone suffering with IBD and Arthritis as there are no effects on the protection a condom will offer you.
THE PILL
There are two types of pill, the normal one which contains a mix of oestrogen and progesterone and the mini pill which is progesterone only. I was on the pill (Microgynon 30) for a few years before I started trying to get pregnant with Leo. It worked well for me and I had no issues during the time I took it luckily. There are a few options available so if you don’t get along with one type, you can be swapped to a different one. You generally take a daily pill for 21 days, then have a 7 day ‘break’ which is when you have your period. The mini pill can be slightly trickier as you don’t just have to remember to take it every day bur you have to take it at exactly the same time. Everyone with a chronic illness knows fatigue can be a nightmare and so setting an alarm in case you have popped off to the land of nod or got yourself busy in an activity is a must! The problem with taking the pill when you have IBD is the issue of malabsorption. This is a common symptom when flaring and means your body is not absorbing things correctly, often, but not limited to vitamins and minerals from food. If your body doesn’t absorb the hormones in your pill correctly you will be left at risk of it failing and you getting pregnant. Vomiting is also a symptom and could cause you to expel your pill back out the way it went in. Definitely a risky option as you don’t always know you are suffering with malabsorption until it is too late.
THE COIL
This option can seem a little daunting and I was definitely worried when thinking about having this method but most do really well on it and it is very effective. There are two types again, the copper coil which contains no hormones and the mirena which also releases hormones to help its effectiveness. The coil has to be placed by a doctor but can stay in place for up to 5 years, meaning it is good for not having to think about it too much (apart from checking the strings to make sure it is still in place). There are a few downsides to this including that it can be expelled by the body and in very rare cases can pierce the uterus when being placed, but overall this method is a good one and reliable for people with IBD. People with arthritis will have to be able to move into a position similar to when you have a smear done, so if this is a struggle, this method may not be very practical for you.
INJECTION
The injection is given every 8, 12 or 13 weeks depending on which type you are on. It contains hormones which will prevent a pregnancy. This is another good option for anybody who regularly vomits or is on medication as this won’t be affected. However, the injection can cause thinning of the bones and is not recommended for people with arthritis. It also may not be suitable for those with IBD who have suffered with related joint problems or have been on high doses or long term doses of steroids as these can also thin the bones. If you are planning a pregnancy in the near future, it is worth noting that your fertility can take up to a year to return after being on the injection so this may not be practical if you are looking at starting a family sooner rather than later.
IMPLANT
The implant is a small, flexible tube (about 4cm in length) which is inserted under the skin of the upper arm by a doctor. The implant can last up to three years. This is another good, long term option for those who struggle with remembering to take pills or can’t have many of the other options listed above. There are a few possible side effects and a few medicines can impede the implant so this would need to be checked out with your doctor.
PATCH
This is the method I chose to go with. You pop on a patch for a three weeks (changed every week) and then have a patch free week when you have your period. This method is good for people with IBD and Arthritis as it cannot be affected by malabsorption or other medication. The patch can be placed in a few different areas of the body and I try and make sure if I know I am going out (for example when I was bridesmaid) then I put it somewhere out of sight, like on my bottom!
There are a few other options but these are the main ones which are most readily available and most effective. I hope the information I have provided will have helped. If you are looking for more information on this, I recommend visiting the NHS Choices Contraception Guide which is what I looked at to get an idea of what I wanted before I visited my GP. Please feel free to message me or comment below if you have any further questions. You can also pop me a message on Facebook by visiting my page here.
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