Counseling on reproduction, contraception essential in treatment of women with IBD
ORLANDO, Fla. — Due to adverse outcomes associated with unintended pregnancy in women with inflammatory bowel disease, there is an increased need for gastroenterologists to routinely initiate reproductive counseling with female patients, according to a presenter here.
There are two important questions gastroenterologists should ask every woman they treat with IBD, Lori Gawron, MD, MPH, assistant professor in the department of obstetrics and gynecology at the University of Utah, said in a presentation. “The first question is, ‘Would you like to become pregnant in the next year?’”
For women with IBD, it is imperative that pregnancy is planned, she said, as active IBD at the time of conception is associated with a variety of adverse events, including recurrent flares during pregnancy, miscarriage, preterm delivery and low birth weight in addition to the adverse outcomes with unintended pregnancy that affect the general population.
Because of these increased risks, gastroenterologists should understand and discuss the benefits and risks of different contraceptive options available to their patients, Gawron said. For women with IBD with increased risk for venous thromboembolism, for example, the risks associated with combined oral contraceptives generally outweigh the benefits, she said.
Furthermore, studies show women with IBD desire information on pregnancy and contraception from their gastroenterologist, Gawron said, and yet patients do not initiate these conversations, and current educational interventions lack a contraceptive focus.
The second important question gastroenterologists should be asking women is if they notice any cyclical patterns to their disease-related symptoms that coincide with their menstrual cycles, Gawron said, as it is known that patients may have lower quality of life if they have these symptoms. Hormonal contraception and keeping a menstrual diary can improve cyclical symptoms, she said.
Gastroenterologists should ask these two important questions to “every woman, every time, every visit,” Gawron said, “so we can maybe make a difference and improve quality of life for our patients.”
For more information:
Gawron L. Presented at: 2014 Advances in Inflammatory Bowel Diseases, Dec. 4-6, 2014; Orlando, Fla.
Disclosures: Gawrin reports no relevant financial disclosures.