Contraception is an important issue for women and those issues still remain important despite a CKD diagnosis. In fact, they may be even more important if a recent study’s findings are taken into account. The study, published online in Kidney Medicine, shows women of children baring age with kidney disease are less likely to use contraceptives. The study looked at women between the ages of 15 to 44, who were on dialysis and were using Medicare as the primary payer. 35,732 people were looked at. The study found the rate of use was 5.3% for each person to years. Use increased from 4.21 to 6.54% during the study. Use was higher in women who were between the ages of 15 to 24 and lower in the 30 to 34 age bracket. Use decreased as the women became older. In terms of ethnic backgrounds, use was higher in Black women and Native Americans as opposed to white women.
Even though fertility is reduced, conception and delivery are possible in all stages of CKD. While successful planned pregnancies are increasing, unwanted pregnancies may have long-lasting negative effects, hence the importance of birth control. Here’s a rundown of the pros and cons of different birth control methods for those with CKD:
- Progestin is generally safe and well-tolerated, with some menstrual spotting as its main side effect
- Non-medicated intrauterine devices are a good option, although they need to be monitored if a person is at increased risk of pelvic infection.
- Barrier methods like condoms, spermicides and sponges are not only effective, but carry few risks and are the only contraceptives that also protect against STDs.
- Surgical sterilization, due to high risk of surgery is rarely recommended, but in special cases can be considered.
- Emergency contraception with either high-dose progestins or intrauterine devices should be avoided if possible, but are not necessarily contraindicated in serious situations.
- Abortion research in the CKD world is still fairly sparse, but the data we do have has shown similar outcomes to non-CKD sufferers, with one potential risk being increased blood loss in anemics.
Personalized contraception options, as you can see, are still varied and widely available and should be offered to women with CKD, along with an awareness of the benefits and potential risks. Through greater awareness, many women would be better equipped to make informed choices about what fits into their lives best. If you want more information on kidney health issues, be sure to watch the Healthy Kidney Inc. YouTube channel, updated daily.