Considerations for contraception in women with cardiovascular disorders

Article Abstract:

Oral contraceptives (OCs), IUDs and long-acting progestins may be suitable contraceptive choices for women with high blood pressure, mitral valve prolapse or angina pectoris. Angina pectoris is pain in the chest caused by a lack of oxygen flowing to the heart. This lack of oxygen is associated with coronary artery disease. Patients with high blood pressure or angina are at increased risk for heart attack if they become pregnant due to the additional demands placed on the circulatory system. Though OCs have been associated with an increase in blood pressure, the degree of elevation is usually low. Women with high blood pressure can generally take OCs provided that their blood pressure can be controlled through diet, exercise or drug therapy. OCs may prevent the progression of atherosclerosis, a condition which restricts blood flow through the arteries. If women with angina have no other risk factors for cardiovascular diseases, OCs may be a viable option. Mitral valve prolapse is a generally benign disease and women who have no other symptoms can use OCs. IUDs and long-acting progestins are generally safe contraceptive options for women with cardiovascular diseases.

Hypertension, Women, Diseases, Mitral valve prolapse, Angina pectoris

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Contraceptive methods for women with neurologic disorders

Article Abstract:

Women with epilepsy or headaches not associated with neurological symptoms may still be candidates or oral contraceptive (OC) use. However, women who have migraines with neurological symptoms such as numbness or other sensory disturbances should use other forms of contraception. Pregnancy may have serious adverse consequences for women with epilepsy, therefore the need for an effective contraceptive is extremely important. Anti-epileptic medication can decrease the steroid concentration of OCs in some women. For this reason, treatment of epileptic women taking OCs may require careful monitoring or changing levels of the anti-epileptic medication. Women with non-vascular headaches are good candidates for OC use. Studies linking OCs to worsening migraines or strokes tend to be inconclusive. However, women who develop more severe headaches after taking OCs should be advised to use a different method of contraception. Women with any history of stroke should also choose a method other than OCs.

Epilepsy, Migraine

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Diabetes mellitus and fertility control: contraception management issues

Article Abstract:

Oral contraceptives (OCs) and IUDS are probably the best contraceptive choices for diabetic women. It is extremely important that diabetic women not become pregnant until their diabetes is under control and they have sought a physician's advice. Pregnancy may affect not only the diabetic mother but also the fetus. Pregnancy may increase or speed the development of certain complications including high blood pressure, retinopathy and neuropathy. The risks to the fetus include spontaneous abortion and congenital birth defect OCs and IUDs are the best choices for contraception in diabetics because of their high reliability. They also seem to be free of side effects which might adversely affect the diabetic woman, though few long-term studies of the effects of these methods on diabetics have been done. Diabetic women taking OCs should have their insulin and fasting glucose levels monitored regularly.

Diabetes, Diabetes mellitus

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