Celiac disease can affect the choice of contraceptive methods: it is good to evaluate with the doctor whether to rely on the contraceptive pill.
The contraceptive pill is one of the most popular contraceptive systems, both for its practicality and ease of use, and for the effectiveness that reaches 99% from the first days of use. It works by blocking ovulation, thanks to the action of the hormones it contains (estrogen, progesterone, estradiol, in different combinations and dosages depending on the type of pill).
Its effectiveness, like that of all drugs taken orally, can however be compromised by particular conditions of the digestive system that prevent its complete absorption and therefore do not make the active ingredients available in the concentrations necessary for them to be effective. Think, for example, of episodes of vomiting and diarrhea or treatment with antibiotics that modify the intestinal flora, or celiac disease, chronic inflammation of the small intestine triggered by the ingestion of gluten.
Damage to intestinal villi
In people with celiac disease, the ingestion of gluten, a protein complex found in many cereals, triggers an immune reaction that damages the villi of the intestinal mucosa. It is thanks to the villi that nutrients are absorbed through the walls of the small intestine, and then passed into the blood. If the villi are damaged, even if you feed you do not retain nutrients. Or, despite taking medication, you don’t get the desired effects.
Malabsorption affects the activity of the drug
A gluten-free diet, in almost all cases, “turns off” the disease. Progressively the damaged intestinal villi are repaired and the absorption of nutrients in the intestine returns to normal.
When celiac disease is in remission and the specific antibodies (EMA and IgA) are negative there is no contraindication to the use of the hormonal pill, because there are all the conditions for the drug to be absorbed in the correct dosage and can therefore have an effective contraceptive action.
If the remission of the pathology is not yet complete or the woman is not aware that she suffers from coelialchia, the hormones may not be fully absorbed and therefore the pill may lose part or even all of its effectiveness: in the first case, cycle irregularities or blood loss may appear, in the second you may be exposed to the risk of unwanted pregnancies.
When there are problems of malabsorption, therefore, it is safer to opt for other hormonal contraceptive methods, such as the transdermal patch or the vaginal ring, which act independently of the activity of the intestine.
The choice of the right contraceptive is done with the doctor
According to estimates, 5 celiacs out of 6 are not identified and there would be about 248,000 unaware celiac women in Italy. The symptoms, in fact, are often underestimated.
The signs that should alarm are varied from person to person, but the most frequent are some persistent gastrointestinal disorders, such as vomiting, diarrhea, constipation, bloating and abdominal pain, unmotivated weight loss, but also headaches or anemias.
When discussing oral contraceptives with your gynecologist, it is important to report these symptoms as well. This allows the doctor to have all the information to correctly assess the situation and recommend the most suitable contraceptive method to obtain maximum reliability and safety.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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