Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002895 (sickle cell disease)
 11,747 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Since sickle cell disease places women at higher risk of maternal and fetal mortality and morbidity, effective contraception is especially important. The first choice for women with sickle cell disease may be depot medroxyprogesterone acetate (DMPA). In addition to being a highly effective, reversible contraceptive, DMPA also may prevent the painful sickling crises that occur when red blood cells clog the small vessels. Use of oral contraceptives (OCs) by women with sickle cell disease remains controversial. No case-control or prospective cohort studies have examined the relationship between OCs and the formation of blood clots in women with sickle cell disease, but observational studies have failed to detect evidence of adverse effects. Norplant implants do not appear to alter the blood of women with sickle cell disease, but they do not confer the DMPA-associated benefits. Progestin-releasing IUDs, which are not associated with the increased blood loss common with copper IUDs, are another option. A study conducted in Ghana concluded that a switch from barrier methods to more reliable methods such as DMPA, OCs, and sterilization could substantially reduce pregnancy-related death and illness among women with sickle cell disease in sub-Saharan Africa.
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PMID:DMPA good choice for women with sickle cell. 1229 53

Primary care physicians often prescribe contraceptives to women of reproductive age with comorbidities. Novel delivery systems (e.g., contraceptive patch, contraceptive ring, single-rod implantable device) may change traditional risk and benefit profiles in women with comorbidities. Effective contraceptive counseling requires an understanding of a woman's preferences and medical history, as well as the risks, benefits, adverse effects, and contraindications of each method. Noncontraceptive benefits of combined hormonal contraceptives, such as oral contraceptive pills, include regulated menses, decreased dysmenorrhea, and diminished premenstrual dysphoric disorder. Oral contraceptive pills may be used safely in women with a range of medical conditions, including well-controlled hypertension, uncomplicated diabetes mellitus, depression, and uncomplicated valvular heart disease. However, women older than 35 years who smoke should avoid oral contraceptive pills. Contraceptives containing estrogen, which can increase thrombotic risk, should be avoided in women with a history of venous thromboembolism, stroke, cardiovascular disease, or peripheral vascular disease. Progestin-only contraceptives are recommended for women with contraindications to estrogen. Depo-Provera, a long-acting injectable contraceptive, may be preferred in women with sickle cell disease because it reduces the frequency of painful crises. Because of the interaction between antiepileptics and oral contraceptive pills, Depo-Provera may also be considered in women with epilepsy. Implanon, the single-rod implantable contraceptive device, may reduce symptoms of dysmenorrhea. Mirena, the levonorgestrel-containing intrauterine contraceptive system, is an option for women with menorrhagia, endometriosis, or chronic pelvic pain.
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PMID:Contraception choices in women with underlying medical conditions. 2176 49