Contraception Recommendations for Acute Hepatic Porphyrias
What's UP Doc? Is a regular column where we feature a patient question along with a response from a member of the UPA Scientific Advisory Board.
After I was diagnosed with AIP, we had our children tested for porphyria and found out our 17-year-old daughter has the gene for AIP. Should she avoid hormonal birth control? Are there safe options for her?
Today’s answer comes from Dr. Rebecca Karp Leaf of the Massachusetts General Hospital in Boston, MA.
That's a great question. The answer is that it really depends on what she's on birth control for. Would she be taking birth control for heavy periods, for contraception or for both reasons?
Avoiding hormonal contraception would be ideal, if possible. The copper IUD (copper T or ParaGard) has no hormones however it can increase bleeding. There are also low-dose progesterone-only IUDs, Which are well tolerated by some but not all patients.
It really depends on the indication. If it’s just for contraception, I think that the copper IUD is a good place to start. If it's for both contraception as well as heavy menstrual bleeding, we might proceed with a low-dose progesterone IUD with close monitoring.
Thank you to Dr. Leaf for this What's UP Doc? answer! Do you have a question for a porphyria expert? Send it to info@porphyria.org.
Disclaimer
What’s UP Doc? is not intended as medical guidance for individual patients. Any individual care decisions should be made in consultation with your healthcare team. Please contact United Porphyrias to locate a physician in your area, to provide information about porphyria to a current physician, to advise about referral to a specialized porphyria center, or to arrange a peer-to-peer consult between your physician and a porphyria specialist, contact UPA at 800-868-1292 or info@porphyria.org.
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