Gastrointestinal disease and oral contraception

Contraceptive practices in women with cystic fibrosis

“…Given that our OCP group is young, highlights the importance of emphasizing full compliance in patients attending CF clinic. The fact that 94% of women using the OCP were pancreatic insufficient and yet no known contraceptive failures occurred suggests that concerns regarding poor absorption of hormones from the gastrointestinal tract may be overstated [3].…”

“…Concerns have been raised regarding oral contraceptive pill (OCP) usage in CF due to potential malabsorption, and CF liver disease could result in either high serum levels as a consequence of decreased hydroxylated estrogens or decreased serum levels secondary to decreased glucurconide-conjugated estrogens impairing enterohepatic circulation of estrogens [3,4]. There is no difference in sexual practice between CF and age matched females [5] but pregnancy in CF women is associated with increased health care requirements [6,7] The expert opinion of the U.S. CF Foundation Consensus Statement regarding adult care suggests that "issues of female contraception are broadly similar for women with and without CF" [2].…”

All disease begins in the gut: Influence of gastrointestinal disorders and surgery on oral drug performance

“…Malabsorption of BCS Class III and notably fat-soluble drugs such as the androgen therapies may also be affected by the simultaneous impairment of fat absorption due to SI resection and a decrease in available intestinal surface area which again may warrant the selection of drug alternatives for affected patients, or an alternative route of delivery. Other lipophilic drugs such as hydrocortisone, oestrogen and cyclosporine become similarly malabsorbed (Hanker, 1990). In the case of oral antibiotics, however, cephalexin, trimethoprim and metronidazole are well absorbed in the short gut (Menardi and Guggenbichler, 1984).…”

Short small bowel in children. Complications and treatment strategies

“…The lowest levels of levonorgestrel were found in the patients with the largest small bowel resection. Jejunoileal bypass may lead to a reduced bioavailability of norethisterone and levonorgestrel [67].…”