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Provision of contraception services and advice for women with cystic fibrosis
  1. Sarah Gatiss, MRCOG, MFSRH, Consultant Obstetrician and Gynaecologist1,
  2. Diana Mansour, FRCOG, FFSRH, Consultant in Community Gynaecology and Reproductive Health Care2,
  3. Simon Doe, MBBS, MRCP, Specialist Registrar3 and
  4. Stephen Bourke, MD, FRCP, Consultant Physician3
  1. Department of Contraceptive Services, Sunderland Royal Infirmary, Sunderland, UK
  2. Newcastle Contraception and Sexual Health Services, Newcastle General Hospital, Newcastle upon Tyne, UK
  3. Adult Cystic Fibrosis Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  1. Correspondence to Dr Sarah Gatiss, Department of Contraceptive Services, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK. E-mail: sarah.gatiss{at}chs.northy.nhs.uk

Abstract

Background and methodology As the prognosis of patients with cystic fibrosis (CF) improves, issues of sexual health, fertility, pregnancy and contraception are increasingly important. In order to plan the provision of a contraception and sexual health service for women with CF we studied their sexual and reproductive history, their current usage of contraception, the sources and quality of advice they had received, and their particular needs using a confidential questionnaire sent to all women over 16 years of age attending a regional CF centre.

Results Of 55 women (mean age 29.7 years) surveyed, 42 (76%) responded. Thirty-three women (79%) were sexually active and 13 (31%) had experienced 19 pregnancies, five (26%) of which were unplanned. Only half of the women who responded were using contraception. No woman used female sterilisation, the progestogen implant, intrauterine system (IUS) or copper-bearing intrauterine device (IUD) for contraception. Twenty-six (62%) women reported not having received contraceptive advice specific to CF and 24 (57%) said that they had not been warned about the potential interaction between broad-spectrum antibiotics and the combined pill.

Discussion Women with CF have a relatively high rate of unplanned pregnancy and do not receive optimal advice or use the full range of contraceptive methods. CF teams lack training in contraception and contraceptive services may not have a detailed knowledge of CF and its complications. New strategies are needed to focus the knowledge and skills of both teams in providing better services for women with CF.

  • contraception
  • cystic fibrosis
  • fertility
  • pregnancy
  • sexual health care
  • Accepted February 12, 2009.

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