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Variety of contraceptives okay for disabled women. (Not Limited to Depo-Provera).
NEW YORK -- Although contraceptive injection is widely used in mentally and physically disabled women, many of these patients are candidates for a much wider variety of contraceptive methods, according to Dr. Maida Taylor.
"There is a ton of Depo-Provera [medroxyprogesterone acetate] used in women with disabilities, because it requires one injection every 12 weeks and is highly effective in preventing pregnancy. However, it has a host of side effects such as headache and bloating, weight gain, and irritability and is not for everyone. Clinicians should remember that the disabled are not a monolithic group and are capable of using a variety of contraceptives," Dr. Taylor said at a gynecology symposium sponsored by Symposia Medicus.
Dr. Taylor, of the University of California, San Francisco, reviewed several disabilities and diseases and commented on what contraceptives were suitable for affected women:
* Visual impairment and blindness. "If the underlying cause is thrombotic, estrogen-containing methods may be contraindicated," she said, "but there is no evidence that hormonal contraception accelerates microvascular disease in diabetics. Since pregnancy has a high probability of accelerating retinal disease, effective contraception is essential for susceptible insulin-requiring diabetics."
* Stroke, cerebrovascular accident, and head injury. "Barriers and IUDs are okay. If the underlying disorder is thrombotic, then no estrogen-containing contraceptives should be used. Even if the underlying cause was trauma, be cautious with OCs. While the risk of a future [cerebrovascular accident] attributable to OCs is small, any further damage would be devastating in such cases. Contraceptive implant and progestin injectable might be considered with consultation," Dr. Taylor said.
* Cerebral palsy, polio, and muscular dystrophy. "Use oral contraceptives and other estrogen-containing methods as dictated by how active the individual is. Immobility increases risks of venous thrombotic events. If there is impaired bladder function in the patient, a diaphragm may increase ...
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Source: HighBeam Research, Variety of contraceptives okay for disabled women. (Not Limited to...