Birth Control Methods and Their Effects on Women With Chronic Health Conditions

The most important thing for you, if you have a chronic condition, is to have an understanding of birth control methods and how they can affect your health. Some of these methods can present specific concerns for certain rheumatic conditions. If you have antiphospholipid syndrome or antiphospholipid antibodies in your blood, lupus or RA, here is what is known about the concerns and the appropriate birth control methods.

Antiphospholipid antibodies and antiphospholipid syndrome: APL or antiphospholipid antibodies are proteins that affect the balance in the blood between clotting and bleeding and are a risk factor for blood clots. APS or antiphospholipid syndrome, is an autoimmune disorder that is characterized by antiphospholipid antibodies, blood clotting, and miscarriages and the syndrome can happen alone or with lupus, even though you have the antibodies you may not have lupus.

If you have antiphospholipid antibodies you are more likely to develop blood clots if you have another risk factor for blood clotting such as a severe illness, surgery, prolonged bed rest, malignancy, or pregnancy or it can be a lifestyle risk factor such as smoking or using combination contraceptives. That's why this second risk factor can be one of the variants in the blood that makes clotting possible. When you have lupus and antiphospholipid antibodies you are more likely to have other medical risk factors for a stroke or heart attack, like migraines, atherosclerosis or clogged arteries, or elevated cholesterol levels.

Contraceptives with estrogen are know to increase the risk of blood clots and when you have moderate to high antiphospholipid antibodies you should stay away from combination hormonal contraceptives. If you have low or borderline levels of the antiphospholipid antibodies, it may depend on whether you have had other risk factors for blood clots, to determine if you should stay clear from the combination hormonal contraceptives. Progesterone-only contraception is a good alternative for you if you have antiphospholipid antibodies and are unable to safely take estrogen. This method is also an effective way to decrease the heavy menstrual flow if you are on blood-thinning medications like warfarin, also known as Coumadin, which is often used to treat APS, Antiphospholipid syndrome.

Systemic lupus erythematosus: It was thought for many years that estrogen increased disease activity in lupus. This assumption was based on the findings in laboratory animals, and the fact that lupus is found mostly in women, 4 out of 5 people with lupus are women, and the reports of birth control pills and pregnancy where women said their lupus got worse. There are early reports that suggested there was an increase risk of lupus flares with the use of contraceptives containing estrogen. But, there are more recent studies that were better-designed, using large numbers of participants and standardized methods of measuring flares that found that estrogen-containing contraceptives are safe in some women with lupus.

And there were two randomized clinical trials published at the end of 2005 that found combination birth control pills don't significantly increase the risk of flares in women with inactive or stable, moderate lupus. The Safety of Estrogens in Lupus Erythematosus National Assessment, or SELENA, trial included 183 women with inactive or stable, moderate lupus and compared the effects of a standard combination birth control pill with the effects of an inactive placebo pill. Women who had active lupus, a history of blood clots, or antiphospholipid antibodies couldn't take participant in the study and the number and severity of the lupus flares showed no difference in the two groups. There was another study of 162 women with stable mild-to-moderate lupus that also found no adverse effects on flare rates whether the women used a combination pill, a progesterone-only pill or a copper IUD.

Based on these studies, it would appear that combination pills are safe for you if you have inactive or stable, moderate lupus and don't have antiphospholipid antibodies. Remember, though, that you may not even be able to tell how active your lupus is and often lupus activity can only be detected through blood test or other tests. So if you have lupus and you want to use a combination pill, your rheumatologist must be involved in the decision making. Since about 1/3 of the women with lupus have antiphospholipid antibodies, you have lupus you should be screened for the antibodies before starting a combination birth control pill.

It seems that it would be smart for you if you have lupus to avoid the contraceptive patch, Ortho Evra, given the recent FDA warning that it increases the risk of blood clots above that of combination pills. There's also the birth control pills that contain drospirenone, Yasmin, Yaz, that are more likely to elevate blood levels of potassium, an important consideration for you if you have lupus-related kidney problems. The safety of IUDs, if you are taking immunosuppressive drugs to treat your lupus, is not certain, because the drugs and the IUDs can raise the risk of infection. If you have active lupus, barrier methods or progesterone-only contraceptives are your options. Depo-Provera injections may be a problem if you are taking corticosteroids, because both the Depo-Provera and the corticosteroids increase the risk of bone loss.

Rheumatoid arthritis: There are some who believe that if you have RA you might actually benefit from treatment with estrogen-containing birth control pills because your symptoms improve during pregnancy. But, there's little research into using the pill to treat RA and research does suggest that women with RA have normal estrogen levels but lower than normal androgen levels, so hormonal therapy attempts have focused on supplementing androgens (androgens are primarily male sex hormones, but women have small amounts of them), with mixed results and no clear benefit. Postmenopausal estrogen therapy has also been studied in women with RA but showed no effect on the activity of the RA, and although there are no grounds for saying that combination hormonal contraceptives reduce the activity in Ra, there's no evidence that suggest their use would make a flare more likely to happen. Combination pills or the patch, may be effective and convenient for you if you have RA, but there is a concern that the risk of blood clots from the patch is higher than the risk from the pill. Inserting a vaginal ring or a diaphragm may be difficult if you have severe RA and like with lupus, it's not sure how safe IUDs are if you are taking immunosuppressive drugs such as ethotrexate, corticosteroids, or cyclosporine to treat their RA. There are no studies that have addressed this question specifically with newer RA medicines such as the biologics, among them Enbrel, Remicade and Humira.

There are other concerns as well and they are the hormone containing contraceptives can interact with other medicines, and this can reduce your medicine's effectiveness or increase its side effects. Some of these medicines are used to treat arthritis and related conditions. Some anticonvulsants like anti-seizure medications that are used to treat seizures, headaches, or chronic pain disorders may decrease the effectiveness of birth control pills. There are also, corticosteroids, warfin, and cyclosporine that can interact with the contraceptives even though the interactions are weak. Other medications that are used to treat other health conditions, some antibiotics, may also interact with hormone containing contraceptives and if you are using one of these contraceptives you should always remind your doctor of that fact when your doctor prescribes you new medications.

When you have rheumatic conditions and you have to stay in bed for a while, maybe because of a flare-up of the condition, or after surgery you should stop using combination birth control pills, the patch and the vaginal ring. Also, and especially if you have antiphospholipid antibodies, your doctor should give you low doses of a blood-thinning medicine. If you are planning elective surgery, you should talk to your doctor about stopping you combination hormonal contraceptive two months in advance, because estrogen's effects on blood clotting takes up to six weeks to reverse.

5 Simple Get Pregnant Tips for Women Wishing to Conceive After Using Birth Control Methods

So you and your partner have made the decision to start a family and you want a few get pregnant tips. You may currently be using birth control methods for safe sex and to protect yourself from an unplanned pregnancy. This may well have been the case for some time and this is normal. However, now that you and your partner have made that life changing decision to start a family, you must consider coming off whatever method of birth control you have opted to use in the past. This is not necessarily an easy thing to do and it can be a daunting decision for you to make. This is especially the case if you have been using hormonal birth control methods, such as oral contraceptives. These oral contraceptives are more commonly referred to as the pill. Here are some helpful guidance notes for those of you who want to get off birth control for the purposes of conceiving.

    Tip 1 Complete your current cycle of oral contraceptives.

It is now widely recognised from clinical studies that it is advisable to complete your current cycle of birth control pills. Don't stop taking the pills part way through the cycle. It is believed there may be some slight dangers involved when pills are discontinued in mid-cycle. Since these pills are hormonal in nature there could be an impact on the level of bleeding sustained and finishing the cycle should reduce this risk.

    Tip 2 Try to stop taking the pill at least three months before you plan to conceive.

In a perfect world you will plan the conception of your baby for about three months from when you stop taking the pill. This will then allow your body to resume its natural hormonal cycle, which is an important factor for your body as a whole. In addition this "breathing space" will allow for any traces of residual hormones from the pill to get out of your system. It is a sensible step to stop in advance of conceiving to allow your body to stabilise so you can regulate your ovulation in order to chart when are you most fertile.

    Tip 3 Use an alternative method of contraception until the time you want to conceive.

This may seem an odd request and it is often overlooked by many couples, but you need to avoid earlier conception than you had planned. As described in the point above your body needs a short period of time for adjustment before conception. Barrier methods such as condoms are an ideal choice and should prevent you from getting pregnant while your body is still trying to get accustomed to life without the pill. There is a distinct psychological advantage to be gained here in using a reliable alternative method of birth control for the few months before you try to get pregnant. It puts your mind at ease and shields you from the constant worry about if you are pregnant or not. Often when you come off the pill you may experience irregular or even missed periods for a short space of time. However they do not necessarily mean you are pregnant. So, for the sake of your peace of mind, use condoms for a few months.

    Tip 4 Take care of your lifestyle.

By this I mean that you should start a regime of healthy eating, drinking and exercising. This is a massive topic in itself, but it is sufficient for me to suggest that you embark on a healthy lifestyle geared to your individual needs. Eat more fresh fruit and vegetables and drink plenty of water. Exercise is good! Don't overdo it, but regular gentle exercise will help you enormously later down the line when you are pregnant.

    Tip 5 Cut out the bad things!

If you are a smoker then stop now, don't wait till you get pregnant. Ensure your consumption of alcohol and caffeine is kept to a minimum. Your ability to conceive could well be affected by these factors. I don't want to preach to you here but, believe me, it is so important that you get your body into the best possible condition in preparation for conceiving.