Contraception is a very personal decision and one that many people struggle with. It can be even more difficult for those with a stoma to find the right contraception due to the risk of infection. A stoma is an opening in the abdominal wall to allow bowel movements. If you have undergone stoma surgery, there are a few things you need to consider before choosing your contraception method. Many contraceptives come in the form of a pill, injection, or implant, and some can be implanted into the lining of your stoma. Others such as condoms and diaphragms do not affect your stoma at all.
The aftermath of surgery can be a difficult time. You may have had an operation on your uterus or other reproductive organs and are now wondering what to do about contraceptives. For example, an intrauterine device can be used, but it depends on your age and the type of surgery. Suppose you have had a vaginal stoma formed by pulling down the bowel through the abdominal wall to sit at or just above your pubic bone. In that case, an intrauterine device is unsuitable because it sits in the lower portion of the uterus, which is likely to perforate through the bowel into the pelvis. An intrauterine device is generally inserted in a woman who hasn't had any surgery at all, in which case it would sit in the uterus without being able to be felt by you or your GP.
Many people take the contraceptive pill to prevent pregnancy, but they must be aware of some risks. One risk that needs to be discussed with your surgeon before taking the pill is clotting. Any contraceptive pill, including the mini-pill, increases your risk of clotting. The more often you take it, and the longer you take it, the higher your risk. Some women do not realize that they will fully recover from their surgery and may mistakenly continue taking their pills; this can lead to serious problems.
If you have had a bowel stoma formed, it is best not to use contraceptive hormones if they pass through the stoma and enter the abdominal cavity. There are estrogen-containing creams, tablets, or patches that can be used, but you must use condoms as well because all of these forms of contraception remain in the body for up to three days. You cannot rely on using them just before or after sex because they are not always effective at preventing pregnancy.
There are many different types of birth control, but not all work for everyone. Knowing which method might be best for you and your lifestyle before opting for a particular contraceptive. For those with an ileostomy or ileoanal pouch, oral contraception may not be the best option. That's because the medication can pass through your digestive system too fast without it being fully absorbed into your system.
Condoms have been proven to be a reliable and safe form of contraception, as long as they are used correctly. This barrier method can safely be used in addition to the contraceptive pill or as an alternative for those who want more control over their reproductive system. The general advice for men and women considering hormonal contraception is to discuss the risks with their doctor before starting. Women having surgery to treat endometriosis or ovarian cysts or at risk of uterine cancer should avoid using contraceptives containing estrogen.
