Contraception and Crohn's?

[Inwe]

I've had crohn's since I was 17 and I have never been on any contraception ever. I'm looking for a type of contraception that won't irritate my intestines or cause a flare up. (I've been in remission for almost 2 years!!! )

Is there certain types of birth control that I should avoid? There are SSOOO many options out there than I feel like I need some advice on what kind to choose! I've heard some conflicting arguments about the "pill" (or general oral contraception) and how it can aggravate symptoms or not absorb properly?I'm really not keen on the IUD or nuvaring. So has anyone had good experiences with the patch or injection?

Any advice would be very helpful!

 

[SarahBear]

Hi, Inwe!

There isn't any certain type of birth control likely to cause a flare - it would come down to the hormones, so taking one would be much like taking any other. There are, however, a few things to keep in mind. Yes, Crohn's can cause absorption issues if you take the pill (which you wouldn't need to worry about right now, being in remission, but it would be a bit of a mess if inflammation crept up on you and caused issues - however, a backup form of contraception, which is suggested anyways, would ease any worries if it were me). The shot and the implant contain a different kind of hormone that (if taken for more than two years) increase your likelihood of developing osteoporosis - which unfortunately, we're already at a greater risk for due to reoccurring problems with malnutrition and steroid use.

The patch has a slightly greater level of hormones, so it might be more likely to cause you stomach problems and any other side effects, but I wouldn't assume it would cause a flare on it's own.

Why are you opposed to the NuvaRing? I use it and have found it to be the easiest and least disruptive form of birth control I've tried.

It comes down to what you're more comfortable with, as they all have their pros and cons. Most doctors like to start you out on the pill, and if you have any issues with it, you can move on to something else.

 

[theOcean]

I couldn't take oral contraceptives and one -- Alesse -- actually was responsible for sending me into a flare because it made me so sick.

The one that I take is the one by injection, Depo-Provera. I've been on it for a year with no problems. I also asked my doctor about osteoporosis because it runs in my family, but she wasn't too concerned. As long as you get enough calcium (either in your diet or a supplement) you should be fine.

 

[Amanda89]

I would avoid oral contraception as my GI just told me the oter day that people with Crohns don't absorb it correctly. You could try the patch, cool, implant etc.

 

[afidz]

I would avoid oral contraception as my GI just told me the oter day that people with Crohns don't absorb it correctly.

I think that depends on where your Crohn's is located, if there is active inflammation and/or scar tissue build up but I might be mistaken. It is definitely a concern to bring up with your OB/GYN

 

[Amanda89]

Yeah I have to admit, I'd never heard it before so was quite surprised when he told me.

 

[Pusheen]

there are two things to think about here, if you have Crohn's in the higher intestines, it might not be taken up in the bloodstream if you take it as a pill.

the other thing to think about is the higher risk to get blood cloths from the hormones, added to the higher risk that Crohn's already gives you.

But your GI and obs/Gyn should be able to advice you better on this.

 

[Lam123]

When I was your age I went on the pill initially and it didn't agree with me, not sure if it was crohns related or not. I actually tried a few and had horrible side effects. Also, my dr warned me about the increase risk of blood clots. So I then decided to just use condoms. I liked the fact of not putting any extra pills in my body and no bad reactions. It has always worked for me (except when I wanted to get pregnant), I still use them now.
Hope this helps!

 

[StarGirrrrl]

There is a newer kind of Pill (known as the mini pill) which comes with an increased risk of blood clots pretty close to zero.
Always something to discuss with your GI and GYN though, as with everything it's not suitable for everyone.

 

[Lil_Lisa08]

I've had Crohn's for about 4 years now and I have been on the pill for about 8 years. I take Tri Sprintec and haven't had any issues. My OB/GYN knows about my Crohn's and has never brought up any concerns. I haven't gotten preggers yet and I'm quite terrible about taking the pill (usually have to to double up for forgetting) so it must be working.

 

[PsychoJane]

I share similar views with Liam123. Would I take contraceptive I'd be more encline to consider the mini-pill (micronor) which is strictly progesterone. This one has the up side like stargirll was saying to not be problematic regarding blood clots (one of my main concern with contraception and crohn) but it has the down side that you need to be taking it at the same time every day.

Many of my friends are swearing by the Mirena (IUD device) and they find it is very practical considering its good for 5 years, etc etc. It's not perfect but it too can be interesting from the fact its strictly progesterone.

Undercutaneous implant (Norplant - implanon) can be interesting because they can be put in/ taken out if needed but they are not available in Canada (unless it has changed).

I would avoid Depo-Provera considering it can reduce bone mineral density and also because you can't undo the injection if you see what I mean. Considering its every 3 months.

I don't think there is any progresterone only patches so if you want to preserve yourself from the increased risks of blood clot that comes along with crohn, this would possibly not be the best option.

If it is solely for contraception purpose, I would definitively consider progestative over anything else or non-hormonal methods (even though they can be quite annoying). It is always case by case obviously but in theory, your Ob-Gyn should be doing a similar screening with you.

 

[gracifer]

I was having a chat about my GI about this. He told me not to go on the oestrogen - 'normal' pill as its linked Crohn's disease flares, however, the other pill that's got testosterone in it, is fine to take apparently. At least I got a laugh out of it haha..

 

[Inwe]

thanks everyone. I appreciate it! I did talk to a GI (not my personal one, but one of her associates) and she didn't really give me a definitive answer. She basically told anything was probably fine as long as I wasn't in a flare and told me to ask my GP... :/

I'm going to try and see a gynecologist but I remember years ago when I tried to see one (for a different problem), they told me I needed to either be pregnant or have a referral from my GP. And dammit, it takes for freaking EVER to get a non-emergency referral. Le sigh*

And for those who asked... I'm only taking it for pregnancy prevention purposes. I would just use condoms exclusively in other circumstances but I guess I'm always worried about them breaking or using them "incorrectly" (apparently this is pretty common? I didn't realize it was so difficult to use them! ). I'm in a trial drug that's actually working to keep me in remission. And since this is the first time in my life that I've ever truly been in remission I don't want to screw that up and get kicked out of the trial for being pregnant.

 

[Ness1993]

I was on the pill but found that it was not working due to my D the whole time. I then changed to injection and its been amazing.

 

[eleanorruby]

I still swear by condoms--non-hormonal, inexpensive, extremely effective, and even protective against diseases.

 

[theOcean]

The injection (Depo-Provera) has been extremely effective for me. If you're taking it for making sure you don't get pregnant, it actually has a much lower failure rate than condoms and oral contraception. You can see a comparison chart here.

Condoms aren't really an option for me because I'm so sensitive to them (they chafe, badly), and my SO is my first and only partner. We barely use them anymore (and I've been on Depo for over a year), and I haven't had a single scare.

 

[eleanorruby]

That's too bad about the condoms. Do you think it's a brand thing? I know that Trojans are absolutely awful, but I really like Durex Extra Sensitive. It might be worth a shot if you haven't tried them.

 

[theOcean]

That's too bad about the condoms. Do you think it's a brand thing? I know that Trojans are absolutely awful, but I really like Durex Extra Sensitive. It might be worth a shot if you haven't tried them.

Trojans are terrible, and the spermicide on some of them ended up even hurting my SO like crazy. They've made me bleed before. There's also a horrifying report that one type of them actually uses capsaicin, which is a derivative of chili peppers.

I'll ask if my SO remembers trying the Durex ones before though, but even without them (and with lubricant) I still sometimes end up with pain after.

 

[Orchid]

I still swear by condoms--non-hormonal, inexpensive, extremely effective, and even protective against diseases.

For Inwe's purpose (a clinical trial for a drug) they're not considered adequate because of the failure rate due to people ******* up. It's either two more effective means of contraception or abstinence. If she's even suspected of pregnancy she'll likely lose access to her medication.

 

[Inwe]

Trojans are terrible, and the spermicide on some of them ended up even hurting my SO like crazy. They've made me bleed before. There's also a horrifying report that one type of them actually uses capsaicin, which is a derivative of chili peppers.

I'll ask if my SO remembers trying the Durex ones before though, but even without them (and with lubricant) I still sometimes end up with pain after.

Huh. Good to know! I'll keep that in mind since I'm planning on using both condoms and medical controception.

And orchid is right. I would no longer be able to take my medication if I was to get pregant. Sooooo not worth it! Better safe than sorry.

 

[SarahBear]

If you're not sensitive to condoms, you're not likely to have issues with any certain brand. If you are sensitive to them, your sensitivities may lay elsewhere - it's all trial and error.

A combination approach sounds wise in your situation. Have you spoken to your GP? They may be able to start you on something while you wait for a referral to go through.

 

[eleanorruby]

Ugh, that's a rough situation. And wow, I had no idea about the ingredients in Trojans; I just hated them the one and only time I tried them. I actually ended up throwing out the whole box. They felt weird and somehow... wrong and there was a terrible smell in the apartment while we were getting it on. TMI, I know.