What causes reduced effectiveness of oral contraceptives in women with inflammatory bowel disease (IBD)?

Updated: Apr 10, 2020
  • Author: William A Rowe, MD; Chief Editor: BS Anand, MD  more...
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Advise women who have Crohn disease with small bowel disease and malabsorption that oral contraception may have reduced effectiveness. [113] Additional contraception is recommended for women on combined hormonal contraception who are also receiving antibiotic regimens for less than 3 weeks, as well as for 7 weeks following cessation of the antibiotic. Note that certain medications prescribed for rectal or genital use may adversely affect the efficacy of condoms. [113] In addition, consider whether contraceptive agents may have an effect on diseases associated with IBD (eg, osteoporosis, venous thromboembolism, primary sclerosing cholangitis).

In women with IBD who will undergo major elective surgery, combined oral contraception should be discontinued for a minimum of 4 weeks before the procedure. [113] These women should use alternative contraception.

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