Contraceptives May Not Play a Role in Multiple Sclerosis Relapse

Two new reports discuss contraceptive options for patients with multiple sclerosis.

Findings from 2 new studies published in the MS Journal found that oral contraceptives do not increase the risk of relapse among woman with multiple sclerosis (MS), which suggests that the drugs can be safely used by these patients.

MS is most common among women of childbearing age, which can have an influence on family planning. Upon diagnosis, many patients wonder how their condition will affect reproductive abilities and how having a child may affect their conditions, according to the study authors.

In the first study, the authors examined if using oral contraceptives may affect MS relapses. Included in the study were 162 women with MS receiving treatment with interferon of glatiramer acetate for MS.

The authors discovered that among the 81 women using each MS drug, there was no increased risk of relapse based on contraceptive use. Interestingly, patients who used oral contraceptives had significantly lower rates of relapse compared with patients who had never used them, according to the study.

The authors noted that there were no differences in relapses for patients taking different oral contraceptives.

While these findings suggest that patients with MS can safely take oral contraceptives without risk of relapse, the study did not control for age or health behaviors that could influence risk.

The authors plan to analyze how different doses and formulations of contraceptives combined with disease-modifying medications could affect relapse, according to the study.

In the second study, the authors discuss the recent CDC guidance on contraception for patients with MS. Based on current findings, the agency reports that most contraceptives are safe for this population.

The CDC stated that combination hormonal contraceptives, which include estrogen and progestin, should not be used by patients with MS who have prolonged immobility. For these patients, the oral contraceptives may lead to an increased risk of blood clots, according to the study.

Although there are few studies exploring the drug interactions, the guidelines note that disease-modifying therapies do not seem to reduce the efficacy of hormonal contraceptives.

For patients using medications to treat MS that may be harmful to the fetus during pregnancy, the CDC recommends that these patients choose a long-acting method of contraception, including intrauterine devices or implants.

“Although neurologists may frequently refer MS patients to other providers for contraceptive care, neurologists can play a key role in promoting reproductive health by routinely assessing their patients’ pregnancy intentions and helping women make contraceptive choices that factor in their level of disability, immobility, and medication use,” the authors wrote. “When counseling women with MS about contraception, the full range of methods for which they are medically eligible should be discussed in order for women to choose the best method for their personal circumstances.”