Contraception for women with multiple sclerosis: Guidance for healthcare providers.

{"article_title":"Contraception for women with multiple sclerosis: Guidance for healthcare providers.","author":"Houtchens MK, Zapata LB, Curtis KM, Whiteman MK","journal_title":"Multiple sclerosis (Houndmills, Basingstoke, England)","issn":"1477-0970","isbn":"","publication_date":"2017 May","volume":"23","issue":"6","first_page":"757","page_count":"","accession_number":"28338393","doi":"10.1177\/1352458517701314","publisher":"SAGE Publications","doctype":"Journal Article","subjects":"Contraception standards; Contraceptive Agents, Female standards; Contraceptive Devices, Female standards; Multiple Sclerosis; Practice Guidelines as Topic standards; Adult; Female; Humans","interest_area":["Neurology"," Immunology Allergy & Inflammation"],"abstract":"Family planning is essential for any comprehensive treatment plan for women of reproductive age with multiple sclerosis (MS), including counseling on using effective contraception to optimally time desired and prevent unintended pregnancies. This topical review summarizes the first evidence-based recommendations on contraception safety for women with MS. In 2016, evidence-based recommendations for contraceptive use by women with MS were included in US Medical Eligibility Criteria for Contraceptive Use. They were developed after review of published scientific evidence on contraception safety and consultation with experts. We summarize and expand on the main conclusions of the Centers for Disease Control and Prevention guidance. Most contraceptive methods appear based on current evidence to be safe for women with MS. The only restriction is use of combined hormonal contraceptives among women with MS with prolonged immobility because of concerns about possible venous thromboembolism. Disease-modifying therapies (DMTs) do not appear to decrease the effectiveness of hormonal contraception although formal drug-drug interaction studies are limited. Neurologists can help women with MS make contraceptive choices that factor their level of disability, immobility, and medication use. For women with MS taking potentially teratogenic medications, highly effective methods that are long-acting (e.g. intrauterine devices, implants) might be the best option.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=28338393&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Houtchens MK, Zapata LB, Curtis KM, Whiteman MK","Journal_Info":"Publisher: SAGE Publications Country of Publication: England NLM ID: 9509185 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1477-0970 (Electronic) Linking ISSN: 13524585 NLM ISO Abbreviation: Mult Scler Subsets: MEDLINE","Publication_Type":"Journal Article; Review","Published_Date":"2017-05-01","Source":"Multiple sclerosis (Houndmills, Basingstoke, England) [Mult Scler] 2017 May; Vol. 23 (6), pp. 757-764. Date of Electronic Publication: 2017 Mar 24.","Languages":"English","Electronic_ISSN":"1477-0970","MeSH_Terms":"Multiple Sclerosis*, Contraception\/*standards , Contraceptive Agents, Female\/*standards , Contraceptive Devices, Female\/*standards , Practice Guidelines as Topic\/*standards, Adult ; Female ; Humans","Subjects":"Adult, Female, Humans, Contraception standards, Contraceptive Agents, Female standards, Contraceptive Devices, Female standards, Multiple Sclerosis, Practice Guidelines as Topic standards","Title_Abbreviations":"Multiple sclerosis (Houndmills, Basingstoke, England)","Volume":"23"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"28338393","RelevancyScore":"808","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"808.276306152344"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=28338393&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=28338393&authtype=shib&custid=ns346513&group=main&profile=eds"}