This leaflet has been written to provide information about contraception for patients with Cystic Fibrosis. We hope it answers some of the questions or concerns you may have. It is not intended to replace talking with medical or nursing staff and is to be used in conjunction with a discussion with the Cystic Fibrosis Nurse Specialists regarding contraception, fertility and pregnancy. If you are thinking about starting a family, please speak with a member of the Team about this before trying to become pregnant.
Does Cystic Fibrosis alter fertility?
Most women with Cystic Fibrosis have normal or near normal fertility. Women were less healthy in the past and so pregnancy was not common. However, there is less evidence of this today and women have normal pregnancies. The mucous around the neck of the womb tends to be stickier in patients with Cystic Fibrosis but this generally will not prevent pregnancy.
Do antibiotics affect contraception?
Some oral contraception methods can be affected by short term courses of oral or intravenous antibiotics by changing how well the antibiotics are absorbed in the body. It is important to remember that if you have a short course of antibiotics for example for 2 weeks you should take extra precautions for this time and for 7 days after (i.e. condom).
Which contraception can I use?
Condom These work by providing a barrier so that the egg and sperm do not meet. These work by providing a barrier so that the egg and sperm do not meet.
These work by providing a barrier so that the egg and sperm do not meet.
- Advantages It's 85%-98% effective when used correctly It provides protection against sexually transmitted diseases.
- Disadvantages They can fail resulting in the need for emergency contraception.
Oral contraceptives
There are two main forms of oral contraception for women the combined pill which contains both female hormones oestrogen and progesterone and the Progesterone only pill. Research has shown that in Cystic Fibrosis the combined pill shows the same level of protection as in women that don’t have Cystic Fibrosis. Therefore the currently recommended pills should contain 30 micrograms of oestrogen. The progesterone only pill (mini pill) will not be effective in patients with Cystic Fibrosis.
- Advantages Combined pill gives adequate protection and can reduce pre menstrual tension and painful periods.
- Disadvantages If you forget to take them protection is reduced.
Depo-Provera
This is a hormone injection under the skin which is given every 3 months.
- Advantages This is not thought to be affected by antibiotics and lasts for 3 months. Another advantage is you do not have to remember to take a daily pill.
- Disadvantages This may reduce bone density and has to be given as an injection.
Intrauterine Contraceptive Devices (IUCDs) (coil)
These are fitted by a doctor or suitable qualified nurse inside the womb.
- Advantages 98-99% effective These are not affected by antibiotics and can last up to 5 years.
- Disadvantages Some devices may cause heavy and/or painful periods and may be slightly uncomfortable when initially inserted.
Barrier methods
Cervical cap - covers the cervix, may be difficult to position correctly.
Diaphragm - Covers the top of the vagina and is larger and easier to fit.
- Advantages Effective in 92%-96% of women when used correctly.
- Disadvantages Involves interruption of intercourse and can be messy as you need to use a spermicide.
Natural Methods
Withdrawal - the man withdraws before ejaculation
Rhythm - Detecting changes in body temperature and the stickiness of cervical mucous so sex is avoided at times when a woman is fertile. It is important to remember that in Cystic fibrosis the mucous is always thick and a rise in temperature may be a sign of infection.
- Advantages 94%-99% effective when intercourse is restricted to the time after ovulation.
- Disadvantages Can take up to 6 months to learn effectively and need to avoid intercourse at certain times in the month. Stress and illness can make this method unreliable.
Sterilisation
This would involve a surgical procedure.
- Advantages Over 99% effective and involves no hormones.
- Disadvantages Cannot be reversed and involves an operation.
Patch
Patch containing oestrogen and progestogen.
- Advantages 99% or more effective when used correctly and is applied once a week for 3 weeks.
- Disadvantages May be seen on skin, not suitable for women with conditions such as blood pressure or for those over 35 who smoke.
Emergency Contraception
You only have a short period of time after unprotected sex to sort out some emergency contraception. This can be either up to 3 days to obtain emergency contraception pill or up to 5 days for an intrauterine device to be fitted. The earlier you seek advice the better. Emergency contraception is available free from your GP, family planning clinic or Brook Advisory Centre. If you are over 16 years of age you can also buy it at a chemist.
If you have any problems or concerns about the level of cover your current method of contraception offers you or need advice regarding contraception please contact the Cystic Fibrosis Nurse Specialists Monday – Friday 8am-4pm on: 0151 600 1374.
Further information
- www.cftrust.org
- CF Trust helpline: 08458591000
- Liverpool Brook Centre: www.brook.org.uk or 0151 207 4000/0808 802 1234
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