Multiple Sclerosis Experts Offer Guidelines on Contraceptive Use Among Women with MS

Multiple Sclerosis Experts Offer Guidelines on Contraceptive Use Among Women with MS

Two studies that recently appeared in the Multiple Sclerosis Journal shed light on how contraceptive use may affect women with MS, as well as how the disease might affect the safety and effectiveness of birth-control medications.

Relapsing MS patients treated with older drugs such as interferons and Copaxone (glatiramer acetate) have a lower risk of relapse if they previously used oral contraceptives, found one study, “Oral contraceptives and MS disease activity in a contemporary real-world cohort,” which used data from the Comprehensive Longitudinal Investigation of Multiple Sclerosis at Boston’s Brigham and Women’s Hospital.

Researchers recruited 162 women with relapsing disease, of which half were treated with interferons and half with Copaxone. They divided women into previous, current and never-users of oral contraceptives.

Data showed no increased risk of relapse in women using oral contraceptives. Those who had used contraceptives in the past had significantly lower relapse rates compared to women who never used birth-control pills; however, the team found that the lower annualized relapse rate in current users relative to never users was insignificant.

The National MS Society — which co-funded the study together with the National Institutes of Health — underscored that although researchers did not detect an increased risk, the study didn’t take factors such as age and certain health behaviors into account. These factors can potentially influence both contraceptive use and relapse rates.

According to a National MS Society press release, other studies are underway, which explore the effects of specific doses and types of contraceptives in combination with both injectable and oral disease-modifying drugs.

Meanwhile, guidelines for healthcare staff on how to handle contraception in MS, caution about the use of combined hormonal contraceptives — containing both estrogen and progestin — in women who have limited mobility, since these drugs increase the risk of blood clots.

The publication — “Contraception for women with multiple sclerosis: Guidance for healthcare providers,” made it clear that MS is now among the conditions for which specific contraception recommendations exist. Researchers at the Atlanta-based Centers for Disease Control and Prevention, which developed the guidelines, also said that despite the scarcity of studies on drug interactions, nothing indicates that disease-modifying treatments lower the effectiveness of hormonal contraception.

Besides describing the guidelines, the article outlined the evidence that led to the recommendations. Other than warning women with limited mobility about combination contraceptives, researchers underscored that long-acting contraceptive methods are the best choice for women taking drugs that may cause birth defects.

“This study and the guidelines provide further information to women with MS and healthcare professionals about the general safety of contraceptives, along with important considerations,” the National MS Society said. “Women are encouraged to discuss and concerns about pregnancy or contraception with their healthcare providers.”

5 comments

  1. Ella says:

    Please consider a study of first use of oral contraceptives and MS diagnosis. Are stats/data kept relating to this? I had been on oral contraceptives for six weeks prior MS diagnosis.

    Also, are stats/data kept relating to painful/heavy periods and MS diagnosis/history?

  2. Jo says:

    I’m certain Tecfidera is having a negative effect on my Yaz contraception. I’m now having a period halfway through the month & I take Yaz religiously, same time every day.

    For the CDC to say it’s fine then follow up with admitting there haven’t been many studies…seems irresponsible.

  3. Bernadette P says:

    I stopped oral contraceptives, did not menstruate until three months after (felt pretty well during those three months); and upon beginning my menstruation cycle, everyday since then (it’s now been four months) I’ve felt horrible. I have RRMS. It’s as if everyday has been an exacerbation/relapse with my walking. I’m effected in my right lower extremity. I don’t know what to do or if I should seek a specialist. My main neurologist has offered little advice. I’ve regressed from stopping my oral contraceptive. What can I do?

    • heather says:

      just curious on how your doing now my daughter is experiencing ms like symptoms shortly after the nexplanon i think we are going to take out today but not sure if what other options there is or if it’s a good idea to take BC? she had trouble walking at times also comes and goes 😜

    • Altia says:

      I found this article in search of info about whether birth control pills benefit RRMS. Over the past year I’ve found that my symptoms increase significantly when I am on the placebo pills of my BC pack each month. It makes me dread my period all the more! I figure that my experience makes sense if pregnancy might be protective against MS, that symptoms may decrease during pregnancy, and that BC pills mimic pregnancy but I haven’t found any articles that say so. Hearing that other women have had experiences similar to mine make me wonder what science is missing about this possible phenomenon. BC protection against MS symptoms? I’m about to start my placebo pills and I’m considering just starting another pack of active pills. I know the potential negative side effects of BC, especially of extended periods of time, but I’m trying to measure the risk benefits… sigh. So many questions.

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