Contraceptive Preferences and Knowledge in Women with Inflammatory Bowel Disease
Overview
A survey of 338 women with inflammatory bowel disease (IBD) revealed that 74% used contraception, with oral contraceptives and barrier methods most common, but long-acting methods were underutilized. Women prioritized contraceptive effectiveness, ease of use, and minimal side effects, yet only 25% had discussed reproductive issues with their IBD clinicians despite high comfort levels for such discussions.
Background
Inflammatory bowel disease often affects women during their reproductive years, and active disease at conception is linked to adverse pregnancy outcomes. Unplanned pregnancies, frequently due to contraceptive failure, increase risks for both mother and fetus. Despite the importance of contraception counseling in this population, data on healthcare professional guidance and patient contraceptive preferences in women with IBD are limited. This study aimed to fill this gap by assessing contraceptive use, knowledge, and values among women with IBD in the UK.
Data Highlights
Parameter
Value
Number of women surveyed
338
Contraceptive use
74%
Oral contraceptive pill use
28%
Barrier method use
18%
Long-acting contraceptive use
20%
Long-acting use in active disease
23%
Long-acting use in remission
17%
Discussed reproductive issues with IBD clinician
25%
Comfortable discussing reproductive issues
85%
Preferred counseling sources - IBD nurses
79%
Preferred counseling sources - GPs
75%
Preferred counseling sources - IBD doctors
68%
Preferred counseling sources - Gynecologists
49%
Key Findings
74% of women with IBD reported using contraception, with oral contraceptives (28%) and barrier methods (18%) most common.
Only 20% used long-acting contraceptive methods, despite their higher effectiveness.
Women with active IBD were more likely to use long-acting contraception (23%) compared to those in remission (17%).
Effectiveness (78%), ease of use (75%), and minimal side effects (68%) were the top contraceptive priorities.
Only 25% had discussed reproductive issues with their IBD clinician, although 85% were comfortable doing so.
Preferred sources for reproductive counseling were IBD nurses (79%), general practitioners (75%), IBD doctors (68%), and gynecologists (49%).
Clinical Implications
Healthcare providers should proactively engage women with IBD in discussions about contraception, emphasizing the benefits of long-acting methods given their superior effectiveness. Education efforts should focus on addressing knowledge gaps and aligning contraceptive counseling with patient preferences for ease of use and minimal side effects. Utilizing multidisciplinary teams including IBD nurses and general practitioners may enhance counseling reach and effectiveness.
Conclusion
Women with IBD demonstrate clear preferences for effective, user-friendly contraceptives but often lack adequate counseling and knowledge. Improved education and proactive reproductive health discussions by healthcare professionals are essential to optimize contraceptive use and pregnancy outcomes in this population.
References
Gawron et al. 2014 -- Contraceptive use in women with IBD
European Crohn’s and Colitis guidelines -- Contraceptive considerations
by Jimmy K Limdi, Sarah Rhodes, Eleanor Liu, Anish J Kuriakose Kuzhiyanjal, Matthew Brookes, Jennifer Farraye, Rachel Cannon, Elisabeth Woodhams, Francis A Farraye
