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Contraception with a stoma – what you need to know

19th July 2021

Following stoma surgery, contraception may be the last thing on your mind, but further down the line it maybe worth discussing your options with your Surgeon or Stoma Care Nurse. Your Practice Nurse at your GP surgery will also be very helpful, as they are involved in family planning clinics and are best placed to advise on the various types of contraception.  It is wise to consider your own individual circumstances depending on your situation and look at what might suit you best now you have a stoma.

Most contraceptives are effective for people with or without a stoma, such as barrier methods ie condoms, the cap, or a uterine device such as the coil, the contraceptive pill, birth control injection or patch, men may even have vasectomies as a more permanent way of family planning. Yet there are some contraceptives which need to be used cautiously with certain types of stoma due to the type of surgery you have had and/or changes in your anatomy.

The contraceptive pill with a stoma:

If you are wanting to take the contraceptive pill after stoma surgery, it is important this is discussed with your surgeon first. After stoma surgery, you will be generally less mobile than usual during the first few weeks and months of recovery. It is important to be keeping moving around, even on a low level, to prevent any blood clots developing. Taking the contraceptive pill puts you at a slightly higher risk, hence its use needs to be discussed after surgery before taking.

Ileostomy and ileo-anal pouch:

It is important to note; oral contraception is always not advisable for those with an ileostomy or ileo-anal pouch. Depending how much of your small bowel has been removed during the surgery, medication can pass through your digestive system too fast without it being fully absorbed into your system, as a result it may decrease the contraceptive pill’s effectiveness. If your small bowel is not absorbing the medication, you may have your dose adjusted by your GP or you may be advised to try other methods of hormonal contraception, such as injections, implants or birth control patch.

Colostomy:

If you have a colostomy, pay attention to any foods which may upset your digestive system. Observe for any loose output or diarrhoea which may lead to the contraceptive pill not being absorbed properly.

Morning after pill

The same applies to the absorption of the morning after pill, there is a chance it will be less effective and therefore a risk of pregnancy. Speak with your health care if you feel there is a chance you could be pregnant.

Condoms

Condoms are a very reliable and safe option of contraception, if used correctly and consistently. This barrier method can safely be used in addition to the contraceptive pill.

It is wise to consider this form of contraception whilst you are having any chemotherapy to fully protect your partner from the effects of cytotoxic drugs or other medications which may put them at risk.

Changes in anatomy after surgery:

Depending on the type of stoma surgery you have had, the anatomy of the vagina or uterus may have changed slightly. Therefore caps, diaphragms, coils and IUD (uterine devices) may not feel comfortable anymore and/or insertion and retention of these devises may also be affected. It would be advisable to speak with your Surgeon after surgery about this form of contraception to see whether this is an option for you.

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