According to many gynecologists and endocrinologists, diabetes today is not even considered as a disease, but as a condition that requires constant self-monitoring. And with proper and adequate adherence to the diet and regular intake of hypoglycemic agents (subcutaneous insulin or oral pills), the patient’s well-being does not cause any concern, a person can lead an absolutely normal lifestyle: play sports, work, travel, give birth and raise children – one In a word, live and enjoy every day.
A woman with diabetes can give birth to healthy children, but if pregnancy is not yet in her plans, it is necessary to take care of reliable contraception that is suitable for her particular state of health, because with diabetes there are certain features that you still have to take into account. Let’s consider this question in more detail.
diabetes and pregnancy
Even today, unfortunately, there are cases when women with diabetes do not have complete information about the appropriate high-quality and reliable methods of contraception. That is why, according to objective medical statistics:
- in 77% of cases, pregnancy in women with diabetes is not planned;
- almost every second pregnancy ends in an induced abortion;
- more than 60% of women have a history of multiple abortions.
Why do women so often have to resort to artificial termination of pregnancy? The main reason, as a rule, is considered to be complications associated with diabetes mellitus, frightening with their possible exacerbations. We are talking about heart disease, vascular macro- and micropathology, problems of the gastrointestinal tract, as well as troubles with the urinary system.
How to be?
We are planning a pregnancy
If you take care of preparing for the conception of a baby in advance, you can avoid many troubles and, importantly, maintain your own calmness and positive attitude. Where should you start?
- It is necessary to normalize the level of glucose in the blood.
To identify and cure gynecological and extragenital diseases.
Make sure that diabetes compensation is achieved and maintained for at least three (and ideally six) months before the planned conception.
If these rules are carefully observed, there can be no doubt that the frequency of complications of pregnancy and childbirth will decrease significantly.
Types of contraception
To date, it has been proven that in diabetes mellitus, the use of estrogen-containing hormonal preparations as contraceptives is undesirable. But you should not worry about this, because there are many other ways and methods to prevent unwanted pregnancy.
- Barrier methods (condom, vaginal diaphragm) – a simple method, but its effectiveness is low.
- Coitus interruptus – the effectiveness is also low and there is a risk of developing sexual disorders.
- Chemical methods (Pharmatex drug) – unfortunately, allergic reactions are possible, the effect is quite short-lived, but the risk of developing sexually transmitted infections is significantly reduced.
- IUD (intrauterine device) is a method of invasive contraception, highly effective, quickly reversible (pregnancy can occur immediately after the removal of the device), convenient in terms of lack of connection directly with sexual intercourse, but there is a risk of developing an ectopic pregnancy.
- Mirena, an intrauterine device containing levonorgestrel, is a highly effective but invasive method. It has a minimum of contraindications and has a therapeutic effect.
Hormonal releasing systems are distinguished by their parenteral route of administration and convenient modes of use (weekly, monthly and long-term). For example, the NovaRing releasing system is an elastic transparent ring that a woman can independently insert into the vagina.
COCs (combined oral contraceptives) are a very effective method of contraception, have additional therapeutic effects, are highly reversible, and when the drug is discontinued, pregnancy occurs fairly quickly. However, the method requires a high level of self-discipline.
Optimal contraception for diabetes
What are the advantages and features of the most modern method of protection – combined oral contraceptives?
COCs (combined oral contraceptives) can be prescribed to a woman with type 1 and type 2 diabetes, regardless of the presence of vascular or other complications. Moreover, low- or micro-dose COCs with an ethinylestradiol content of less than 30/20 μg can be successfully used in patients in a state of compensation or subcompensation of carbohydrate metabolism.
What do we have today? Most often, doctors prefer single-phase microdosed tablets, among which there are such names as Novinet, Logest, Mercilon, Lindinet, Mirelle, Jess.
The first oral contraceptive was registered in 1960. In subsequent years, all the efforts of the pharmaceutical industry were aimed at ensuring that the side effects from the use of combined oral contraceptives were minimal. As a result, significant advances have been made in the development of new contraceptive technologies, including the transition from high-dose combined oral contraceptives to low-dose drugs.
In addition, drugs such as combined injectable contraceptives, combined hormonal patches and vaginal rings, progestogen birth control pills and implants have appeared. Today, hormonal contraceptives are chosen by more than 70 million women worldwide. Such popularity is justified, first of all, by the degree of reliability of this method – 99%.
In any case, the consultation of a gynecologist-endocrinologist is absolutely necessary, since it is the specialist doctor who will be able to recommend the best method of contraception for each woman. And listening to his opinion means taking care of your own health and the health of your baby. And what could be more important for a future mother?
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