Crohn's disease and contraception

Last reviewed 05/2022

Inflammatory bowel disease (IBD) and Contraceptive Choice

• women can be informed that a causal association between combined oral contraception (COC) use and onset or exacerbation of IBD is unsubstantiated
  
  
• women should be advised that the efficacy of oral contraception is unlikely to be reduced by large bowel disease but may be reduced in women with Crohn's disease who have small bowel disease and malabsorption
  
  
• health professionals should consider the impact of IBD-associated conditions such as venous thromboembolism, primary sclerosing cholangitis and osteoporosis, and other medical conditions when prescribing contraception to women with IBD
  
  
• women using combined hormonal contraception should use additional contraception while taking antibiotic courses of less than 3 weeks, and for 7 days after the antibiotic has been discontinued
  
  
• health professionals should check whether any prescribed medications for rectal or genital administration contain products that may reduce the efficacy of condoms
  
  
• women with IBD should stop COC at least 4 weeks before major elective surgery and alternative contraception should be provided. Advice regarding recommencing COC should be given individually
  
  
• laparoscopic sterilisation is an inappropriate method of contraception for women with IBD who have had previous pelvic or abdominal surgery
  
  
• women with IBD considering sterilisation, and their partners, should be counselled about alternative methods of contraception including long-acting reversible contraception (LARC) and vasectomy

Reference:

• 1) FSRH (2009).Sexual and Reproductive Health for Individuals with Inflammatory Bowel Disease.