Skip to main content

Contraception for Women with Diabetes

  • Chapter
  • First Online:
Diabetes in Women

Part of the book series: Contemporary Diabetes ((CDI))

  • 1212 Accesses

Abstract

Today, diabetic women have an increasing variety of safer and effective contraceptive methods. While more contraceptive trials in diabetic women are needed, data from existing studies and extrapolation from clinical trials in healthy women support the use of most contraceptive methods. This chapter will review contraception in women with type 1 (DM1) and type 2 (DM2) diabetes mellitus, with or without sequelae. It will also review contraception in prediabetic women, e.g., with previous gestational diabetes mellitus to augment the limited studies in women with DM2. The goal will be to provide a simple question-based approach to individualized counseling, considering diabetic sequelae and comorbidities, metabolic effects, and lifestyle demands.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Clausen TD, Mathiesen E, Ekbom P, Hellmuth E, Mandrup-Poulsen T, Damm P. Poor pregnancy outcome in women with type 2 diabetes. Diabetes Care 28:323–328, 2005

    Article  PubMed  Google Scholar 

  2. Towner D, Kjos SL, Leung B, Montoro MM, Xiang A, Mestman JH, Buchanan TA. Congenital malformations in pregnancies complicated by NIDDM. Diabetes Care 18:1446–1451, 1995

    Article  CAS  PubMed  Google Scholar 

  3. Gilbert C, Valois M, Koren G. Pregnancy outcome after first trimester exposure to metformin: a meta-analysis. Fertil Steril 86:658–663, 2006

    Article  CAS  PubMed  Google Scholar 

  4. Piaggio G, Grimes DA, Van Look PFA. Task Force on Postovulatory Methods of Fertility Regulation Timing of emergency contraception with levonorgestrel or the Yuzpe regimen. Lancet 353:721, 1999

    Article  CAS  PubMed  Google Scholar 

  5. Spellacy WN, Buhi WC, Birk SA. The effect of estrogens on carbohydrate metabolism: glucose, insulin and growth hormone studies on one hundred seventy-one women ingesting premarin, mestranol and ethinyl estradiol for six months. Am J Obstet Gynecol 114:388–392, 1971

    Google Scholar 

  6. Perlman JA, Russell-Briefel R, Ezzati T, Lieberknecht. Oral glucose tolerance and the potency of contraceptive progestins. J Chronic Dis 338:857–864, 1985

    Article  Google Scholar 

  7. Fahmy K, Abdel-Razik, Shaaraway M, et al. Effect of long-acting progestagen-only injectable contraceptives on carbohydrate metabolism and its hormonal profile. Contraception 44:419–429, 1991

    Article  CAS  PubMed  Google Scholar 

  8. Konje JC, Otolorin EO, Ladipo AO. The effect of continuous subdermal levonorgestrel (Norplant) on carbohydrate metabolism. Am J Obstet Gynecol 166(1 Pt 1):15–19, 1992

    CAS  PubMed  Google Scholar 

  9. Wilson ES, Cruickshank J, McMaster M, et al. A prospective controlled study of the effect on blood pressure of contraceptive preparations containing different types of dosages and progestogen. Br J Obstet Gynaecol 91:1254–1260, 1984

    Article  CAS  PubMed  Google Scholar 

  10. Singh K, Viegas OA, Koh SC, Ratnam SS. The effect of long-term use of Norplant implants on haemostatic function. Contraception 45:141–153, 1992

    Article  CAS  PubMed  Google Scholar 

  11. Fajumi JO. Alterations in blood lipids and side effects induced by depo-provera in Nigerian women. Contraception 27:161–175, 1983

    Article  CAS  PubMed  Google Scholar 

  12. Shaaban MM, Elwan SI, Abdalla SA, Darwish HA. Effect of subdermal levonorgestrel contraceptive implants, Norplant, on serum lipids. Contraception 30:413–419, 1984

    Article  CAS  PubMed  Google Scholar 

  13. Meade TW. Oral contraceptives, clotting factors and thrombosis. Am J Obstet Gynecol 142:758–761, 1982

    CAS  PubMed  Google Scholar 

  14. Shaaban M, Elwan SI, El-Kabsh MY, Farghaly SA, Thabet N. Effect of levonorgestrel contraceptive implants, Norplant, on blood coagulation. Contraception 30:421–430, 1984

    Article  CAS  PubMed  Google Scholar 

  15. Godsland IF, Crook D, Simpson R, et al. The effects of different formulations of oral contraceptive agents on lipid and carbohydrate metabolism. N Engl J Med 323:1375–1381, 1990

    Article  Google Scholar 

  16. Liew DFM, Ng CSA, Yong YM, et al. Long term effects of depo-provera on carbohydrate and lipid metabolism. Contraception 31:51, 1985

    Article  CAS  PubMed  Google Scholar 

  17. Speroff L, DeCherney A. Evaluation of a new generation of oral contraceptives. The Advisory Board of the New Progestins. Obstet Gynecol 81:1034–1047, 1993

    CAS  PubMed  Google Scholar 

  18. Fahraeus L, Sydsjo A, Wallentin L. Lipoprotein changes during treatment of pelvic endometriosis with medroxyprogesterone acetate. Fertil Steril 45:501–506, 1986

    Google Scholar 

  19. Deslypere JP, Thiery N, Vermeulen A. Effect of long-term hormonal contraception in plasma lipids. Contraception 31:633–642, 1985

    Article  CAS  PubMed  Google Scholar 

  20. Haiba NA, et al. Clinical evaluation of two monthly injectable contraceptives and their effects on some metabolic parameters. Contraception 39:619–632, 1989

    Article  CAS  PubMed  Google Scholar 

  21. Kesserü EV, et al. A multicentered, two-year, phase III clinical trial of norethisterone enanthate 50 mg plus estradiol valerate 5 mg as a monthly injectable contraceptive. Contraception 44:589–598, 1991

    Article  Google Scholar 

  22. Smallwood GH, et al. Efficacy and safety of a transdermal contraceptive system. Obstet Gynecol 98:799–805, 2001

    Article  CAS  PubMed  Google Scholar 

  23. Visser J, Snel M, Van Vliet HAAM. Hormonal versus non-hormonal contraceptives in women with diabetes mellitus type 1 and 2 (review). The Cochrane Collaboration, http://www.thecochranelibrary.com., Issue 1, 2008

    Google Scholar 

  24. The World Health Organization Medical Eligibility Criteria for Contraceptive Use, 3rd edition 2004, http://www.who.int/reproductive-health

    Google Scholar 

  25. Dong W, Colhoun HM, Poulter NR. Blood pressure in women using oral contraceptives: results from the Health Survey for England 1994. J Hypertens 15:1063, 1997

    Article  CAS  PubMed  Google Scholar 

  26. Heimemann LA, Lewis MA, Thorogood M, et al. Case-control study of oral contraceptives and risk of thromboembolic stroke: results from International Study on Oral Contraceptives and Health of Young Women. BMJ 315:1502, 1997

    Google Scholar 

  27. Petitti DB, Sidney S, Bernstein A, et al. Stroke in users of low-dose oral contraceptives. N Engl J Med 335:8, 1996

    Article  CAS  PubMed  Google Scholar 

  28. Lidegaard O. Oral contraceptives, pregnancy and the risk of cerebral thromboembolism: the influence of diabetes, hypertension, migraine and previous thrombotic disease. Br J Obstet Gynaecol 102:153, 1995

    Article  CAS  PubMed  Google Scholar 

  29. Gillum LA, Mamidipudi SK, Johnston SC. Ischemic stroke risk with oral contraceptives: a meta-analysis. JAMA 284:72–78, 2000

    Article  CAS  PubMed  Google Scholar 

  30. Khader YS, et al. Oral contraceptives use and the risk of myocardial infarction: a meta-analysis. Contraception 68:11–17, 2003

    Article  CAS  PubMed  Google Scholar 

  31. Tanis BC, et al. Oral contraceptives and the risk of myocardial infarction. N Engl J Med 345:1787–1193, 2001

    Article  CAS  PubMed  Google Scholar 

  32. Collaborative Group for the Study of Stroke in Young Women. Oral contraceptives and stroke in young women: associated risk factors. JAMA 231:718, 1975

    Article  Google Scholar 

  33. Lidegaard O. Oral contraceptives and risk of cerebral thromboembolic attack: Results of a case-control study. BMJ 306:956, 1993

    Article  CAS  PubMed  Google Scholar 

  34. WHO Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Ischaemic stroke and combined oral contraceptives: results of an international, multicentre, case-control study. Lancet 348:498, 1996

    Article  Google Scholar 

  35. Selber C, Babrouche E, Fagan J, Myint E, Wetterneck T, Wittemyer M. Prescribing oral contraceptives for women older than 35 years of age. Ann Intern Med 138:54–64, 2003

    Google Scholar 

  36. Skouby SO, Jensen BM, Kuhl C, et al. Hormonal contraception in diabetic women: acceptability and influence on diabetes control of a nonaldkylated estrogen/progestogen compound. Contraception 32:23–31, 1985

    Article  CAS  PubMed  Google Scholar 

  37. Skouby SO, Molsted-Pedersen, Kuhl C, et al. Oral contraceptives in diabetic women: metabolic effects of four compounds with different estrogen/progestogen profiles. Fertil Steril 46:858–864, 1986

    CAS  PubMed  Google Scholar 

  38. Radberg T, Gustafson A, Skryten A, et al. Oral contraception in diabetic women. Diabetes control, serum and high density lipoprotein lipids during low-dose progestogen, combined oestrogen/progestogen and non-hormonal contraception. Acta Endocrinol 98:246–251, 1981

    CAS  PubMed  Google Scholar 

  39. Peterson KR, Skouby SO, Sidelmann J, Molsted-Pedersen L, Jespersen J. Effects of contraceptive steroids on cardiovascular risk factors in women with insulin-dependent diabetes mellitus. Am J Obstet Gynecol 171:400–405, 1994

    Google Scholar 

  40. Peterson KR, Skouby SO, Vedel P, Haaber AB. Hormonal contraception in women with IDDM. Diabetes Care 18:800–806, 1995

    Article  Google Scholar 

  41. Klein BEK, Moss SE, Klein R. Oral contraceptives in women with diabetes. Diabetes Care 13:895–898, 1990

    Article  CAS  PubMed  Google Scholar 

  42. Garg SK, Chase HP, Marshal G, Hoops S, Holmes DL, Jackson WE. Oral contraceptives and renal and retinal complications in young women with insulin-dependent diabetes mellitus. JAMA 271:1099–1102, 1994

    Article  CAS  PubMed  Google Scholar 

  43. Ahmed SB, Hovind P, Prving H-H, Rossing P, Price DA, Laffel LM, Lansang MC, Fisher NDL, Hollenberg NK. Oral contraceaptives, angiotensin-dependent renal vasoconstriction, and risk of diabeteic nephropathy. Diabetes Care 28:1988–1994, 2005

    Article  CAS  PubMed  Google Scholar 

  44. Skouby SO, Anderson O, Saurbrey N, et al. Oral contraception and insulin sensitivity: in vivo assessment in normal women and women with previous gestational diabetes. J Clin Endocrinol Metab 64:519–523, 1987

    Article  CAS  PubMed  Google Scholar 

  45. Skouby SO, Kuhl C, Molsted-Pedersen, et al. Triphasic oral contraception: metabolic effects in normal women and those with previous gestational diabetes. Am J Obstet Gynecol 153:495–500, 1985

    CAS  PubMed  Google Scholar 

  46. Kjos SL, Shoupe D, Douyan S, et al. Effect of low-dose oral contraceptives on carbohydrate and lipid metabolism in women with recent gestational diabetes: results of a controlled, randomized, prospective study. Am J Obstet Gynecol 163:1822–1827, 1990

    CAS  PubMed  Google Scholar 

  47. Kjos SL, Peters RK, Xiang A, Thomas D, Schaefer U, Buchanan TA. Contraception and the risk of type 2 diabetes mellitus in Latina women with prior gestational diabetes mellitus. JAMA 280:533–538, 1998

    Article  CAS  PubMed  Google Scholar 

  48. Chasan-Taber L, Willett WC, Manson JE, Spiegelman D, Hunter DJ, Curham G, et al. Prospective study of oral contraceptives and hypertension among women in the United States. Circulation 94:483–489, 1996

    CAS  PubMed  Google Scholar 

  49. Xiang AH, Kawakubo M, Kjos SL, Buchanan TA. Long-acting injectable progestin contraception and risk of type 2 diabetes in Latino women with prior gestational diabetes mellitus. Diabetes Care 29(3):613–617, 2006

    Article  CAS  PubMed  Google Scholar 

  50. Farley TMM, Rosenberg MJ, Rowe PJ, Chen J-H, Meirek O. Intrauterine devices and pelvic inflammatory disease: an international perspective. Lancet 339:785–788, 1992

    Article  CAS  PubMed  Google Scholar 

  51. Skouby SO, Molsted-Pedersen L, Kosonen A. Consequences of intrauterine contraception in diabetic women. Fert Steril 42:568–572, 1984

    CAS  Google Scholar 

  52. Kimmerle R, Weiss R, Berger M, Kurz K-H. Effectiveness, safety and acceptablilty of a copper intrauterine device (CU Safe 300) in type I diabetic women. Diabetes Care 16:1227–1230, 1993

    Article  CAS  PubMed  Google Scholar 

  53. Kjos SL, Ballagh SA, La Cour M, Xiang A, Mishell DR Jr. The copper T380A intrauterine device in women with type II diabetes mellitus. Obstet Gynecol 84:1006–1009, 1994

    CAS  PubMed  Google Scholar 

  54. Gosen C, Steel J, Ross A, Springerbett A. Intrauterine contraception in diabetic women. Lancet 1:530–535, 1982

    Article  Google Scholar 

  55. Lawless M, Vessey MP. Intrauterine device use by diabetic women. Br J Fam Plann 7:110–111, 1982

    Google Scholar 

  56. Wiese J. Intrauterine contraception in diabetic women. Fert Steril 28:422–425, 1977

    CAS  Google Scholar 

  57. Stewart A, et al. The effectiveness of the levonorgestrel-releasing intrauterine systems in menorrhagia: a systemic review. BJOG 108:74–86, 2001

    Article  CAS  PubMed  Google Scholar 

  58. Rogovskay S, Rivera R, Grimes DA, Chen P-L, Bosny P-L, Prilepskaya V, Kulakov V. Effect of levonorgestrel intrauterine system on women with type 1 diabetes: a randomized trial. Obstet Gynecol 105:811–815, 2005

    Article  Google Scholar 

  59. Campbell OM, Gray RH. Characteristics and determinants of postpartum ovarian function in women in the United States. Am J Obstet Gynecol 169:55–60 1993

    CAS  PubMed  Google Scholar 

  60. Perez A, Labbok MH, Queenan JT. Clinical study of the lactational amenorrhoea method for family planning. Lancet 339:968–970, 1992

    Article  CAS  PubMed  Google Scholar 

  61. Kennedy KI, Rivera R, McNeilly AS. Consensus statement on the use of breastfeeding as a family planning method. Contraception 39:477–496, 1989

    Article  CAS  PubMed  Google Scholar 

  62. Labbok M, Perez A, Valdes V, et al. The lactational amenorrhea method (LAM): a postpartum introductory family planning method with policy and program implications. Adv Contracept 10:93–109, 1994

    Article  CAS  PubMed  Google Scholar 

  63. Quality Care in Family Planning. Medical Eligibility Criteria for Contraceptive Use. Geneva: World Health Organization Reproductive Health and Research, 2000

    Google Scholar 

  64. Truit ST, Fraser AB, Grimes DA, Gallo MF, Schulz KF. Combined hormonal versus nonhormonal versus progestin-only contraception in lactation. Cochrane Database Syst Rev (2):CDC003988, 2003

    Google Scholar 

  65. World Health Organization (WHO). Selected Practice Recommendations for Contraceptive Use. Geneva, Switzerland: WHO, 2002

    Google Scholar 

  66. Faculty of Family Planning and Reproductive Health Care Clinical Effectiveness Unit. Family Planning and Reproductive Health Care Guidance (July 2004). Contraceptive choices for breastfeeding women. J Fam Plann Reprod Health Care 30:181–189, 2004

    Article  Google Scholar 

  67. ACOG Educational Bulletin No 258. Breastfeeding: Maternal and Infant Aspects. Washington DC: American College of Obstetricians and Gynecologists 2004 Compendium of Selected Publications, 2004

    Google Scholar 

  68. Zhou L, Xiao B. Emergency contraception with Multiload Cu-375 SL IUD: a multicenter clinical trial. Contraception 64:107–112, 2001

    Article  CAS  PubMed  Google Scholar 

  69. Stage E, Nøgård, Damm P, Mathiesen E. Long-term breast-feeding in women with type 1 diabetes. Diabetes Care 29:7714, 2006

    Article  Google Scholar 

  70. Schaefer-Graf UM, Hartmann R, Pawliczik J, Passow D, About-Dakn M, Vetter K, Kordonouri O. Association of breast-feeding and early childhood overweight in children from mothers with gestational diabetes mellutis. Diabetes Care 29:1105–1107, 2006

    Article  PubMed  Google Scholar 

  71. Public Affairs Committee of Teratology Society. Teratology Public Affairs Committee Position Paper: maternal obesity and pregnancy. Birth Defects Res A Clin Mol Teratol 76:73–77, 2006

    Article  Google Scholar 

  72. Stuebe AM, Rich-Edwards JW, Willett WC, Manson JE, Michels KB. Duration of lactation and incidence of type 2 diabetes. JAMA 294:2601–2610, 2005

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Humana Press, a part of Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Kjos, S.L. (2009). Contraception for Women with Diabetes. In: Tsatsoulis, A., Wyckoff, J., Brown, F. (eds) Diabetes in Women. Contemporary Diabetes. Humana Press. https://doi.org/10.1007/978-1-60327-250-6_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-250-6_9

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60327-249-0

  • Online ISBN: 978-1-60327-250-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics