From the Research
The best birth control method for patients with Ehlers-Danlos syndrome (EDS) is typically a progestin-only option, such as the levonorgestrel intrauterine device (LNG-IUD), as it provides effective contraception with minimal systemic effects and can reduce menstrual bleeding, as seen in a case report of a 16-year-old female with vascular EDS who underwent placement of the LNG-IUD with significant improvement in bleeding and high satisfaction 1.
Key Considerations
- Progestin-only options, such as the LNG-IUD, the etonogestrel implant (Nexplanon), or progestin-only pills (norethindrone 0.35mg daily), are recommended as they avoid estrogen, which can worsen joint hypermobility and vascular complications in EDS patients.
- The LNG-IUD is particularly beneficial as it provides 3-7 years of protection with minimal systemic effects and can reduce menstrual bleeding, which helps prevent iron deficiency in patients prone to bleeding issues.
- Patients should avoid combined hormonal contraceptives containing estrogen as these may increase the risk of vascular complications, particularly in vascular-type EDS.
- Barrier methods like condoms are also safe but have higher failure rates with typical use.
Individualized Approach
- When considering contraception for EDS patients, it's essential to account for individual symptoms, EDS subtype, and comorbidities, with consultation between gynecology and genetics specialists being ideal for personalized recommendations 2.
- A study of pediatric and adolescent patients with EDS found that progestin-only pills were most commonly used, but the LNG-IUD was the most popular final choice of treatment, highlighting the importance of individualized care 2.
Recent Evidence
- A recent case report demonstrated the safe and effective use of the LNG-IUD in an adolescent with vascular EDS, providing evidence for its potential as a suitable option for menstrual management in individuals with vascular EDS 1.