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Sickle cell diseases and hormonal contraception.

H M Freie

    Acta Obstetricia Et Gynecologica Scandinavica
    |January 1, 1983
    PubMed
    Summary

    Oral contraceptives are safe for women with sickle cell disease. Modern low-dose combined pills are recommended for all women carrying the sickle cell gene.

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    Area of Science:

    • Hematology
    • Reproductive Endocrinology

    Background:

    • Sickle cell disease presents unique challenges for reproductive health.
    • Historically, oral contraceptives (OCs) were often contraindicated in patients with sickle cell anemia due to theoretical risks.
    • Recent evidence suggests a re-evaluation of this stance is warranted.

    Purpose of the Study:

    • To review available data on the safety and efficacy of oral contraceptive agents in patients with sickle cell diseases.
    • To assess whether sickle cell anemia is an absolute contraindication for oral contraceptive use.
    • To determine the optimal contraceptive method for women carrying the HbS gene.

    Main Methods:

    • Systematic review of existing literature and clinical data.
    • Analysis of studies reporting on the use of oral contraceptives in patients with sickle cell disease.
    Keywords:
    BiologyCardiovascular EffectsContraceptionContraceptive Methods--indicationsContraceptive Methods--side effectsDiseasesFamily PlanningHematological EffectsHemic SystemHemoglobin LevelHereditary DiseasesOral Contraceptives, CombinedOral Contraceptives--indicationsOral Contraceptives--side effectsPhysiologyReproductive Control Agents

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  • Evaluation of reported effects of steroids on the sickling phenomenon.

    • Main Results:

    • Current evidence does not support the contraindication of oral contraceptives in sickle cell anemia.
    • Several reports indicate potential favorable effects of steroids on the 'sickling' process.
    • No significant adverse events directly attributable to low-dose combined OCs were highlighted in the reviewed data.

    Conclusions:

    • The contraindication of oral contraceptives in sickle cell anemia is not supported by available evidence.
    • Modern low-dose combined oral contraceptives are considered a safe and effective contraceptive choice.
    • All patients carrying the HbS gene can be offered low-dose combined oral contraceptives for family planning.