Contraception for chronic inflammatory bowel disease
Sexuality, partnership and family planning are closely linked to health, enjoyment of life and personal well-being. Issues such as contraception, pregnancy and childbirth play a crucial role in this regard. Young women in particular are often preoccupied with the question of which contraceptive method is best for them. The choice is huge and the decision is therefore not always easy. For people affected by chronic inflammatory bowel disease, there are often additional uncertainties. Many people with IBD ask themselves how the medication they are taking, the current course of the disease or past operations can influence the contraceptive methods. It is therefore crucial to find an individual solution together with the treating gynecologist in order to reliably protect yourself from an unwanted pregnancy with the right contraception. In this blog post, you can find out more about contraception for chronic inflammatory bowel disease.
Contraception for CED
As the course of the disease, the medication taken and the personal needs of IBD sufferers differ from person to person, it is not possible to make a general recommendation for contraception with IBD. For example, it is possible that the medication used for treatment may affect certain organs, such as the liver. Contraceptives that also have an effect on these organs can therefore be an additional burden. Furthermore, fistula formation in the genital area could play a role in intrauterine contraceptive methods, i.e. methods that are inserted directly into the uterus, and make the insertion of an IUD, for example, more difficult. Due to the various situations to be considered, it is therefore crucial to always discuss the contraceptive method with the doctor treating you and adapt it to your personal situation.
Various contraceptive methods
IBD such as Crohn's disease or ulcerative colitis is often associated with an absorption disorder, i.e. an inadequate absorption of substances. However, as the active ingredients of orally ingested contraceptives are absorbed in the upper sections of the small intestine, which are not affected in many IBD patients, the effectiveness of orally ingested preparations is usually guaranteed under stable disease conditions. However, during acute flare-ups or with severe diarrhea, the passage may be accelerated so that the absorption of the active ingredient is reduced or completely prevented. In such a case, contraception may be limited.
One example is the contraceptive pill. Their active ingredients enter the bloodstream via the small intestine after ingestion. If there is severe diarrhea, absorption can be impaired, which reduces the contraceptive effect. Furthermore, hormonal contraceptives can generally represent an additional burden depending on the phase of the disease. In addition, the risk of thrombosis plays a central role in hormonal methods to prevent unwanted pregnancy, as this can be increased in IBD sufferers anyway. In this context, progestin-only preparations or non-hormonal contraceptive methods are often discussed in medical consultations.
Non-hormonal methods, on the other hand, are generally not directly affected by IBD. Condoms, for example, have the additional advantage of protecting against sexually transmitted diseases. With intrauterine contraceptive methods, anatomical changes, such as fistula formation in the genital area, can play a role and make it difficult or even impossible to insert a copper IUD, for example. Which solution is the right one ultimately depends on the individual health situation and should always be discussed carefully.
Conclusion
Contraception for chronic inflammatory bowel disease requires individual advice, as disease activity, medication and possible operations can influence the effectiveness and tolerability of individual methods. While hormonal preparations are usually reliable under stable conditions, their effect may be limited during acute flare-ups. The potentially increased risk of thrombosis in IBD patients should also be taken into account. Non-hormonal methods are generally less affected by the disease itself, but can be complicated by anatomical changes. It is important that the choice of contraceptive method is always made in close consultation with the treating gynecologist and is seen as a shared responsibility within the partnership.
Quick facts:
Under stable conditions, hormonal preparations are usually reliable. However, the effect may be limited during acute attacks.
Non-hormonal methods are generally less affected by the disease itself, but can be complicated by anatomical changes.
Contraception for chronic inflammatory bowel disease requires individual advice, as disease activity, medication and possible operations can influence the effectiveness and tolerability of the individual methods.
CED-despite-me. (2019, September 16). Hormonal contraception #despiteCED: Tips from the specialist. CED-despite-me. https://www.ced-trotzdem-ich.de/den-alltag-gestalten/partnerschaft-und-freundschaft/hormonelle-verhuetung
DCCV e.V. (2025). Sexuality, contraception and the desire to have children. DCCV e.V. https://www.ced-kids.de/meine-seiten-teens/familie-freundinnen-beziehung/sexualitaet/
Dr. Bach, B. (2022, February 2). Chronic inflammatory bowel disease and the desire to have children: ECCO guideline on pregnancy updated. ÄrzteZeitung. https://www.aerztezeitung.de/Medizin/ECCO-Leitlinie-zur-Schwangerschaft-aktualisiert-426984.html
GyneFix. Chronic diseases and contraception. GyneFix. https://verhueten-gynefix.de/faq/chronische-krankheiten-verhuetung/
Holl, K. (2021, August 22). Chronically ill: Contraception and the desire to have children. Pharmazeutische Zeitung. https://www.pharmazeutische-zeitung.de/verhuetung-und-kinderwunsch-127425/seite/7/?cHash=c2cd1ab3ed670a0aae83b2c13b5ac9dd
Kanis, A. (2022, October 11). Chronic inflammatory bowel disease: Recommendations for IBD range from diet to contraception. Medical Tribune. https://www.medical-tribune.de/medizin-und-forschung/artikel/empfehlungen-bei-ced-reichen-von-ernaehrung-bis-verhuetungsmethode
Krohn, K., Pfeifer, M., Manzey, P. et al. Chronic inflammatory bowel disease - the biopsychosocial reality in childhood and adolescence. Federal Health Gazette 63, 839-845 (2020). https://doi.org/10.1007/s00103-020-03166-z
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