Each method of contraception, especially hormonal contraception belonging to pharmacological methods of contraception, should always be selected individually. This is especially important when a woman has a chronic disease. See what method of contraception to use when you have diabetes, thyroid disease, epilepsy or hypertension?

There is no disease that would make it impossible to choose an effective and at the same time safe for a womanmethod of contraception . It is not always easy, and often requires cooperation between doctors of various speci alties, but you can always find some way to enable fertility regulation for women who are not planning to become pregnant or should not become pregnant - not only for personal reasons, but above all for he alth reasons.

Hormone pills, IUD and condom - contraindications

Women with thromboembolism cannot usehormone tabletswith estrogens. This also applies to women who are immobilized due to disability, accident or surgery. Such tablets should be avoided by women after stroke, with deep vein thrombosis, pulmonary embolism, and also with factor V Leiden mutation (congenital, mutated coagulation factor that promotes thromboembolic changes). For women in these groups, progestogen pills are the contraceptive of choice. An intrauterine device (intrauterine) and a condom are also good methods.

Lipid disorders - methods of contraception

Common Ethinylestradiol contraceptive pills should not be used by women with lipid disorders as this estrogen increases LDL cholesterol and reduces HDL levels. Pills with a low dose of progestogen do not have this effect.

The tablet of choice will then be (available in pharmacies for 2 years) a tablet containing natural estradiol, which improves lipid parameters. Estrogens do not harm women who have high cholesterol with normal blood pressure. In women with high blood pressure and lipid disorders, the intake of hormonal pills should be monitored by more frequent examination of the lipid profile and blood pressure measurement.

Diseases of the thyroid gland - methods of contraception

Despite taking hormones that heal thyroid ailments, there are no restrictions on the use of hormonal contraception, as well as barrier contraception, IUDs or patches. The areas and mechanisms of action of the taken hormones are different.

Hepatitis B and C - contraceptive methods

Women infected with the hepatitis C virus should not use any hormonal contraception as it is always a burden for the damaged liver. If a woman has sex, she should use a barrier method of contraception, e.g. disks, condoms, which will additionally protect her partner against infection. The situation is different with the type B virus. If the liver is not damaged, hormonal contraception is allowed, but under the close supervision of a gynecologist and a specialist in liver diseases. It is worth knowing that in both cases, pregnancy may be a threat to the woman and the child.

Facts about contraception

Cardiovascular diseases - methods of contraception

These diseases are favored by: smoking, obesity, diabetes, hypertension, increased lipid levels and age. Some of these factors, such as obesity, are not in themselves a contraindication to estrogen pill use. But when two risk factors such as smoking and obesity come together, OC should be avoided. Combined oral contraception is not used in women with ischemic heart disease or valvular disease because of the increased risk of embolism, pulmonary hypertension, fluid retention or endocarditis. But if a woman regularly takes medications that reduce blood clotting because she has an implanted artificial valve - she can take hormones, as the anticoagulant drugs used in her eliminate the risk of embolism.

Diabetes - contraceptive methods

When the disease is well-balanced, it reduces the risk of birth defects and high glucose-induced miscarriages in early pregnancy. Therefore, women should use contraception until their diabetes is controlled. Combined tablets increase the concentration of glucose and insulin. If a woman, apart from diabetes, has no vascular disease or other cardiovascular burden, and the diabetes does not last more than 20 years - she can take estrogens, but under strict control. When blood sugar levels rise, tablet-taking should be discontinued. Women with type 1 or type 2 diabetes may also use an IUD because it is not associated with the risk of more frequent inflammation of the pelvic organs. Hormonal contraception is allowed for women with gestational diabetes. Long use of low-dose tablets does not increasethey are at risk of developing diabetes. A local progestin-releasing insert is also recommended.

Epilepsy - contraceptive methods

The use of hormonal contraceptives does not increase the susceptibility to seizures. The number of attacks may decrease as progestogens raise the seizure threshold. But some drugs used to treat epilepsy make the low-dose pills less effective. The same is true of patches and discs that contain ethinylestradiol and a progestin. A regular IUD or a hormone-releasing device (Mirena) can be recommended.

Migraine - contraceptive methods

Women who get migraines with aura are at risk of having a stroke and therefore - regardless of age - should not take the combined pill. Ladies over 35 years of age suffering from migraines without aura are also at risk of stroke, so if they choose combined hormonal contraception, they must use it under strict medical supervision. If migraine headaches or other headaches worsen while taking combined contraceptive pills, the dose of the estrogen or progestogen is reduced, or the pills are discarded and replaced with another method of contraception. When headaches occur during your period, your doctor will usually advise you to continue using the combined pill (monophasic only), the diaphragm or the patch.

Hypertension - contraceptive methods

Hypertension increases the risk of complications associated with taking hormonal contraceptives. The risk of a stroke is then 3-10 times higher (it depends on age) than in he althy women. In the case of high hypertension or vascular changes, preparations with estrogens are contraindicated. Women with mild to well-controlled hypertension can use progestogen-only pills and non-hormonal methods such as copper IUDs.

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