Inflammatory Bowel Disease

Can the Contraceptive Pill Cause IBD?

May 28, 2018

In years past, women who might be at risk for inflammatory bowel disease (IBD) were counseled against taking an oral contraceptive pill (“the pill”) due to the impact it might have on the risk of IBD. In particular, there were several studies that showed that women who use the pill might be at heightened risk of developing Crohn’s disease.

The jury remains out on whether the pill could be a trigger for IBD or to get an IBD flare-up.

For women who have IBD, contraception is an important subject, and there are just so many choices. Pregnancy in women with IBD ought to be planned beforehand, and for a lot of women, this pill is a cheap, effective, and easily accessible choice to stop pregnancy. Women at risk of IBD and that have IBD must weigh their birth control choices carefully and talk with their doctors regarding how their health may be affected.

The Evidence Supporting the Link

The evidence on the relation between the pill and IBD is conflicting. There are a few older studies that suggested there was a risk of developing IBD for women taking the pill, yet still other research which found there was not any connection between the pill and IBD. The methods and results of some of the studies have since come into question, and the evidence linking IBD along with the pill is generally regarded as weak.

One meta-analysis of 14 studies concluded that taking oral contraceptives may increase the risk of developing IBD, and particularly Crohn’s disease.

Girls who smoked cigarettes and took the pill for a long period of time proved especially found to be at risk. There’s some speculation that smoking and taking oral contraceptives work together to boost the possibility of developing Crohn’s disease. Crohn’s disease is sometimes known as a”disorder of smokers,” and people with Crohn’s disease are advised to not smoke due to the risk of a flare-up.

Another meta-analysis of all 10 studies found that women who used the pill and had IBD were not at an elevated risk for having a flare-up. This study also discovered that girls who had ulcerative colitis and have been taking oral contraceptives had an identical concentration of hormones in their blood as wholesome women. This would indicate that the girls with ulcerative colitis from the 2 studies contained in the study were able to consume the pill in addition to the wholesome women.

A prospective cohort analysis of 117,375 women in the USA showed that women who take oral contraceptives and smoke are at a heightened risk of ulcerative colitis. The risk of Crohn’s disease has been also improved in those who took oral contraceptives.

The Most Important Thing

At this time, there is not enough proof to conclude 1 way or another that oral contraceptives may lead to IBD. Most studies show that other factors (like smoking) are also involved with the increased probability of IBD in girls who take the pill.  For girls with IBD, pregnancy ought to be proposed during a time when the IBD is in remission or quiescent. A pregnancy could also indicate recovery from abdominal surgery. Therefore, using contraceptives to avoid an accidental pregnancy during specific times in the span of IBD is important.

For girls with IBD, the potential side effects of oral contraceptives should be weighed against the dangers of an unintended pregnancy.

Oral contraceptives are extremely popular due to their ease of use, their accessibility, and their effectiveness. For many women, other forms of birth control are not a good alternative because they’re difficult to use or because they might not be used consistently. If you are at risk of IBD, or you’ve got IBD, and you are considering the use of oral contraceptives, you should discuss any concerns you have with your gynecologist along with your gastroenterologist. Your healthcare team can best assist you to decide the kind of birth control which will be most effective for you.