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Diabetes in Women: Contraceptive Challenges & Solutions

Contraception allows you to have a safe sexual life and enables you to choose whether you want to have a baby or not. Although it does not protect you from sexually transmitted infections, it surely is not stopped by diabetes in women.

Since there are various contraceptive choices available, on World Contraception Day, we tell you all about the challenges of contraception and their solution. Hence, read on!

Diabetes in Women: Types of Contraception

Diabetes in Women Contraceptive Challenges & Solutions

Women with diabetes must speak to their diabetes educator, along with their doctor to understand the best contraceptive method for them. You may still try a few of them before you finalise what is right for you. Here are the types of contraception and who is it suitable for:

  •    Combined oral contraceptive pill –These type of birth control has both oestrogen and progestin present and is suitable for women with diabetes who do not have any complications.
  •    Progestin-only contraceptive pill –A type of pill that has only progestin present and is recommended to all types of diabetic women.
  •    Condoms (male and female) –Although least reliable than other options, this is suitable for all women with diabetes
  •    IUD (hormonal and copper) –Appropriate for all diabetic women
  •    Male sterilisation (vasectomy) –A choice if you feel the need not to have any more children
  •    Female sterilisation (tubal ligation) –Minorly risky as it involves a surgery
  •    Vaginal ring –Best for women with diabetes who do not have any complications
  •    Jadelle contraceptive implant – Appropriate for all type of diabetic women
  •    Fertility awareness – Not reliable in comparison to other methods and hence less suitable
  •    ECP – Appropriate for emergency situations 
  •    Depo Provera injection –Suitable for diabetic women with no serious complications

Diabetes in Women: Challenges and Solutions to Different Types of Contraceptives

All types of contraceptives have their sets of advantages and disadvantages. Moreover, each type of contraception has a varied effect on sugar levels. The following talks about the different types of contraceptives for women with diabetes along with their challenges and solutions.

➔   Oral Contraceptive Pill

Birth control pills fall under two categories:

– Combined oral contraceptive pill 

– Progestin-only contraceptive pill 

As mentioned above, the combined oral contraceptive pill contains both oestrogen and progestin, whereas the latter only contains progestin. It is generally recommended to go for the combined oral pill as it enables to control irregular bleeding. Moreover, this also helps in reducing the pain altogether and help in menstrual pain. The progestin-only pill is recommended to women with diabetes who have problems with oestrogen or are breastfeeding.

Benefits Drawbacks
Helps in menstrual pain Must be taken on a daily basis
Controls irregular bleeding May have side effects such as headaches, nausea, or high blood pressure
Often helps in acne problems Might not work if you are suffering from vomiting

 

➔   Condoms

Condoms are the easiest, most convenient, and immediate form of contraception which helps you in birth control. It also helps you in protecting your body from sexually transmitted diseases or STIs. Condoms are available in supermarkets or even online and can be used by both men and women. 

 Although condoms are advised at all times, it is not the best form of the contraceptive method when it comes to birth control. As per studies, 18 in every 100 women is likely to get pregnant with a male condom whereas 21 in every 100 women with female condoms.

 Nevertheless, if you are someone who has a sexually active life with multiple partners, it is always advisable to use condoms.

 

Benefits Drawbacks
Easily available and convenient Not the best form of birth control method
Prevents you from STDs and STIs

 

➔   Intrauterine contraception

Intrauterine contraception involves the process of using a small IUD device that is placed inside the uterus. The IUD device is available in two forms:

– Copper IUD

– Hormonal IUD (levonorgestrel-releasing intrauterine system)

The hormonal UID is made out of flexible plastic with a nylon string attached to it. A UID device placed inside a womb can last for 5-10 years. In fact, this type of birth control method allows you to sit and relax as they are one of the most reliable forms of contraceptives. According to recent studies, one out of every 100 women fell pregnant using this method. Moreover, this process is reversible and allows the body to return to fertility by simply taking out the device.

Benefits Drawbacks
A highly effective form of birth control Must be inserted inside the uterus
A long-term solution for preventing pregnancy Copper UID bit recommended to women with heavy bleeding as it increases the amount of vaginal bleeding
No requirement to remind anything on a daily basis Slightly risky to get a pelvic infection during insertion
Reversible in nature – once the UID device is taken out, fertility is back to normal Although least likely, the uterus can push out the UID device

  

➔   Implant

Implanting is a process that involves implanting the hormone progestogen into the skin using local anaesthesia. One of the best benefits of an implant is that it can be reversed if someone is suffering from side effects. Moreover, this form of birth control is known to be very effective in nature. Studies indicate one in every 100 women are likely to fall pregnant using this method.

Benefits Drawbacks
A highly reliable, inexpensive and effective form of birth control Must be inserted and removed by a trained doctor, nurse, or midwife
A long-term solution for preventing pregnancy that lasts upto 3 years Can affect your menstrual cycle with significant changes in bleeding pattern
Easily reversible with no effect on fertility This method can also completely stop periods completely

 

➔   Depot injections

Depot injections contain the hormone progestogen to be given every 12 weeks at a very high dose. In fact, this form of birth control has been indicated to be very reliable and effective, with only six out of every 100 women to fall pregnant. Moreover, depot injections are known to help in reducing the pain and works even in conditions of diarrhoea or vomiting.

Benefits Drawbacks
A highly reliable, inexpensive and effective form of birth control Irreversible in nature and can take months to wear off the effect
Helps in reducing or completely stop the pain Can affect your menstrual cycle with significant changes in bleeding pattern
Effective even during vomiting diarrhoea Might lose bone density after injecting

 

Diabetes in Women: Effect of Contraceptives on Type 1 and Type 2 

Now that we understand the benefits and drawbacks of the common types of birth control methods let us know their effect on Type-1 and Type-2 diabetes.

●     Contraceptive pills

Women with diabetes, either Type-1 or Type-2, need not worry before taking a contraceptive pill for birth control. However, studies have also indicated a rise in sugar levels due to estrogen. Estrogen is known to increase insulin resistance in the body. Moreover, diabetic women who take pills for more than two years are likely to have the following complications:

– Diabetic nephropathy or kidney disease

– Diabetic retinopathy or eye disease

– Diabetic neuropathy or nerve disorder

 

●     Intrauterine contraception

Intrauterine contraception has been indicated to have a rare effect on sugar levels. The copper intrauterine devices (IUDs) are a safe and reliable contraceptive option with diabetes in women and has not shown on any effect on Type-2 or Type-2 diabetes. However, the effect of levonorgestrel-releasing IUDs has not been established.

Nevertheless, it has been indicated that intrauterine contraception is one of the safest forms of contraceptives for people with diabetes.

●     Implants

According to recent studies, contraceptive implants are likely to avoid blood clots in women with diabetes and is considered as one of the safest forms of contraceptives. This form of contraception steadily releases the hormone progestogen and therefore reduces the risk of greater risks for diabetics such as heart attacks or strokes. 

●     Depot injections

Since this form of contraception involves a high dosage of progestin to be inserted, there are higher chances of fluctuation in sugar levels, especially in Type-2 diabetics. Moreover, studies have shown depot injections when used as a contraceptive to increase cholesterol levels.

 The safest course of action in all the methods of contraception is to consult your diabetes educator along with your doctor. On World Contraception Day, let us pledge to be aware of all the types of contraceptives and how it affects our sugar levels. 

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