When you have rheumatoid arthritis (RA), choosing to add additional medications/medical devices to your regimen can be a difficult decision. One example is birth control.
Birth control can be contraindicated in some autoimmune diseases if you have certain other comorbidities. But in RA, birth control has been found to be helpful in some cases. I have definitely found that to be the case.
For me, it was a relatively easy decision to begin taking birth control after I got sick. I had been on birth control prior to getting sick, in order to make my extreme periods more manageable. At some point, being otherwise healthy, I stopped taking it.
But when I got sick, one of the things I noticed was that I used to flare terribly before and during my period. So it was a no-brainer to make my periods shorter and easier by going on birth control. This really did have an impact on my body, and was enough to minimize my flaring so that I wasn’t having a flare every single month that would last a week or more. Having to deal with a period is annoying, but dealing with a period and a flare can feel like way too much.
The type of birth control was also an easy decision for me. I opted for a low-dose pill. Since I take other pills, it’s not too hard to remember to take my pill each day. And the low dose tends to minimize the risks, such as blood clots and strokes, that are more prevalent with high-dose methods.
Other delivery methods of hormone-based birth control include a patch, an injection, an implant, and a vaginal ring. These typically are not administered on a daily basis, but tend to be higher dose, and come with a greater risk of side effects.
Another option is an Intrauterine Device (IUD), which is a T-shaped device that a doctor inserts into the uterus. It is unknown whether IUDs can increase the risk of infection, and this tends to be contraindicated in women who are on immunosuppressant medications, including those often used to treat RA.
I have also heard horror stories of women who have had their IUD migrate from their uterus to their abdomen. Plus, for me, anything that I can’t simply stop taking or remove myself definitely puts me on edge. And despite the allure of having a period once a year, such methods seem somewhat unnatural to me.
In terms of pregnancy, it is my personal view to use multiple forms of birth control.
I opt for condoms and a low-dose birth control pill. Many of the medications that are used to treat RA are contraindicated in pregnancy, and with the newer biologic medications, studies in pregnant women have not yet been conducted so there is no way to know whether or not they are safe prior to becoming pregnant and during pregnancy.
For medications contraindicated in pregnancy, I think that being on birth control and preventing the potential harm to a fetus that some RA medications can cause (should you unintentionally become pregnant while taking them) is worth the risk that comes from taking birth control.
Of course, condoms are a non-medical form of birth control. The key with condoms and the pill is that you have to remember to use/take them.
Even though birth control has been helpful to mitigate some of the effects of RA in some people, that doesn’t mean that using birth control should be considered a method of treating RA.
Ultimately, whether or not you decide to go on birth control is a decision that you have to first make personally, and then discuss with your doctor.
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