On November 13th, Young Patients’ AREA hosted our second event of the year: Sex, (Prescribed) Drugs, and Rock n’ Roll: Approaching sexual and reproductive health with an autoimmune disease. In this event, we utilized a new format that included a mix of pre-recorded expert Q&A and live patient-shared experiences.
Dr. Brittany Huynh, pediatric rheumatologist and adolescent medicine specialist whose interests include reproductive health among adolescents and young adults with rheumatic and other complex chronic diseases.
Dr. Erica Brenner, pediatric gastroenterologist and clinical investigator currently investigating reproductive health among young patients with IBD.
Dr. Becca Overbury, rheumatologist with research interests in health care transition in adolescent and young adult patients with childhood and adolescent onset Rheumatic diseases.
Our experts covered a variety of topics including why having conversations about reproductive and sexual health with your disease specialist is important, strategies to start these conversations, and key points patients should know about how their disease and/or medications may interact with their sexual and reproductive health. Below are some of the highlights of what our experts spoke about, but be sure to watch the complete recording to hear their complete insights.
Talking about these topics can be awkward, and doctors know that. To help broach the subject, they recommended strategies such as asking for one-on-one time with your provider (this is also good practice for getting independent in your care!), bringing up these questions early in the appointment to ensure there is plenty of time to discuss, or sending a MyChart message ahead of your appointment if you’d like. These are super important topics to talk about because your condition DOES overlap with your sexual and reproductive health.
In terms of disease/medication interactions with sexual and reproductive health, we learned of risks of blood clots associated with certain conditions such as systemic lupus or Crohn’s disease, which may be further increased when using birth control that contains estrogen. Similarly, individuals with certain autoimmune conditions such as inflammatory bowel disease or those treated with high doses of steroids may be at higher risk of long-term bone density related side effects when using certain forms of birth control, such as Depo Provera (“the shot”). This section was incredibly informative and contained a lot of information I myself hadn’t heard about before, so I highly recommend reviewing the experts’ complete information in this section.
Experts additionally emphasized that in the majority of cases, individuals with autoimmune conditions can have successful pregnancies if they wish to do so. Experts echoed that outcomes are most successful when your condition is well controlled and recommended communicating with your doctor ahead of time to ensure your medications are safe for pregnancy. Dr. Brenner also highlighted preliminary data suggesting that individuals with inflammatory bowel disease who do have trouble getting pregnant and choose to pursue assistive reproductive technology like IVF are just as likely to have a successful pregnancy as somebody without inflammatory bowel disease.
Additionally, a key point brought up by Dr. Huynh emphasized understanding your emergency contraception options, like Plan B or ella: “This is a medicine that you can take no matter what disease you have, no matter what medications you’re taking, and it is safe. So anyone can take it.” Emergency contraception options like Plan B and ella are legal and available in all 50 states, though the more effective option, ella, does require a prescription. Dr. Huynh recommended asking your doctor for a prescription before you even need it so that you can have it on hand.
Other resources recommended by our experts:
- Evidence based guidelines, such as the Reproductive Health in Rheumatic Diseases Guidelines or Preexisting Diabetes and Pregnancy Clinical Practice Guidelines
- Planned Parenthood
- Centers for Young Women’s and Men’s Health
- Scarleteen (less gendered resource)
- Bedsider (lots of information, especially regarding contraception)
- The Brenner Research Lab website offers amazing resources, specifically for patients with Inflammatory Bowel Disease and their providers
- And finally disease organizations and foundations or patient-led organizations also often share valuable resources regarding sexual and reproductive health
The complete recording of this event can be viewed here. All opinions expressed are the personal perspectives of these individuals and not representative of their institutions.
We thank Dr. Huynh, Dr. Brenner, and Dr. Overbury for contributing their time and expertise to this event.
