Contraception is important for people with kidney disease, just as it is for everyone else. Don’t assume that kidney failure will stop everyone having children, for a man or a woman. There are over 10 different methods of contraception available; most of which are suitable for people with kidney disease.
Barrier methods of contraception are effective, so long as they are used carefully. The male condom and female condom (Femidom) also act as a barrier to the spread of sexually transmitted diseases, for example herpes or AIDS. A diaphragm or spermicidal jelly can also be used. Disadvantages of these methods are that men may not like to use a condom. Women may find it difficult to position the Femidom or a diaphragm correctly into the vagina; or find the process distasteful, especially since spermicidal jelly must be used as well, to increase the effectiveness of the contraceptive.
Failure of a barrier method may occur when the device becomes dislodged during or after intercourse. Kidney patients are able to take the ‘morning after pill’, but this treatment can cause sickness and should not be used regularly.
The oral contraceptive pill (often just called ‘The Pill’) can be used in women with kidney diseases, but a low oestrogen type is generally preferred. High blood pressure is very common in women with kidney diseases, and this is also a common side effect of oral contraceptives. Therefore blood pressure should be monitored and sometimes it is necessary to increase the dose of blood pressure drugs.
Women can use an intrauterine coil. This is a small plastic and metal device which is inserted into the neck of the womb. Someone experienced is needed to insert and remove a coil, usually a doctor or nurse. Contraception is generally effective, though the coil may cause some bleeding or heavier periods, and there is a small risk of infection in the womb. There is a new type of coil available, which may suit some people, and may overcome some of the disadvantages of coils. It is marketed in the UK under the name ‘Mirena’, and combines some hormonal treatment with the coil effect. Unlike the old copper coil, Mirena reduces menstrual bleeding and in many cases periods stop completely. In some women on dialysis, this may be an advantage if the blood loss from periods has caused anaemia. Mirena is less likely to raise blood pressure than some oral contraceptive methods, but like any type of medication can have side effects. It needs to be inserted by a doctor and changed every five years.
A man can have a vasectomy or a woman can be sterilised. These procedures can be carried out in people with kidney failure in the same way as anyone else. Before contemplating sterilisation, it is important to realise that the success of reversal by surgery is limited, so if someone changes his or her mind about children, it may not be possible to regain normal fertility. Lastly, sterilisation does not protect against sexually transmitted diseases, so safe sex with barrier methods should be practised if having sex with multiple partners.
These various methods of contraception require consultation with a nurse or doctor in order to decide which would suit someone the best.
The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.