Contraception and multiple sclerosis (MS) - what should be considered?
For many people, love, sex and passion are part of a relationship. This of course also applies if one or both partners have MS. Even with MS, the desire to have children can be realized with a little planning . If there is currently no desire to have children, the choice of a suitable contraceptive is particularly important, especially when being treated with interferons, as these can increase the risk of premature births.
Choosing the right contraceptive is important – what should people with MS know?
Which contraceptives can be used?
In principle, all common contraceptive methods are available to people with MS. One of the biggest concerns of those affected is that contraceptives can have an adverse effect on the course of the disease. According to current knowledge, this is not the case, neither with mechanical nor with hormonal contraceptives. Since complications or intolerances cannot be ruled out in individual cases, you should always consult your treating doctors. Otherwise, the choice of the appropriate contraceptive depends primarily on your current life situation and personal preferences.
Mechanical contraceptives
Mechanical contraceptives are those that prevent sperm from entering the uterus. They are also known as barrier methods. These include condoms, diaphragms and similar. The advantage of these methods is that they only need to be used when necessary. If you want to have a child, you do not need to stop taking them. Since they do not affect your hormone levels, there are no side effects. Particularly important for people with MS: There is no risk of interaction with medications used for MS therapy. However, safe use of barrier methods requires a certain amount of practice. Some couples feel that this limits their spontaneity.
Hormonal contraceptives
This disadvantage does not apply when using hormonal contraceptives. The so-called contraceptive pill is the best known representative of this class, but the market offers a wide range of different products. These also include hormone implants, IUDs or depot injections. They work in a similar way, namely by releasing artificial pregnancy hormones in the body. This prevents sperm from entering the uterus or eggs from implanting there. Some preparations even prevent ovulation. When used correctly, hormonal contraceptives offer a high level of protection that is only surpassed by sterilization. The disadvantage is that they are not always free of side effects. Especially in the first three months after starting use, some women complain of nausea, headaches or mood swings. Some contraceptive pills are also suspected of increasing the risk of thrombosis. If mobility is restricted due to MS, the risk of thrombosis can increase further. Some MS patients also have an increased risk of osteoporosis. This can also be increased by taking preparations that contain the hormone progestin. This is contained in the three-month depot injection or the so-called rod. In addition, the contraceptive methods described here may require a certain amount of time and foresight before the body is ready to conceive again. This shows why detailed consultation with the treating gynecologist and neurologist is essential.
For many people, love and sex are part of a relationship – but there is not always a current desire to have children.
Natural contraceptive methods
There are also natural methods of contraception, such as the time method and the temperature method. With the time method, the length of the cycle is measured and the days that are likely to be fertile and infertile are determined. With the temperature method, the basal temperature is also measured to provide support. At night, the body temperature drops to a minimum, reaching a minimum temperature. This is also known as the basal temperature. The basal temperature must be measured every day immediately after waking up and before getting up. During the days before ovulation, the temperature drops slightly, only to rise again slightly with ovulation. This can be used to determine the fertile days. Neither method is recommended for people with MS, as the disease can cause cycle disruptions and temperature fluctuations.
Studies on the influence of the contraceptive pill on MS
There is speculation in isolated studies as to whether the contraceptive pill can possibly alleviate the course of relapsing MS. This assumption is mainly based on studies by a Portuguese research group led by Armando Sena. Even though the study results sound very promising, they are not yet considered sufficiently proven. There is also evidence from a study in Belgium that taking the contraceptive pill in progressive MS can actually cause the disease to progress. However, this study cannot yet be considered sufficiently substantiated. The studies should therefore be followed with interest at this early stage, but no recommendation can be derived from them. The fact remains: the choice of contraceptive also depends on personal preference for people with MS - for sufficient safety and hopefully a lot of enjoyment in the "most beautiful thing in the world".
