Differenzierte Kontrazeptionsberatung bei neurologischen Grunderkrankungen

Differentiated contraceptive counseling in neurologic diseases

Zusammenfassung

Neurologische Erkrankungen betreffen eine Vielzahl von Frauen im reproduktiven Alter. Die Erstmanifestation der multiplen Sklerose findet häufig in diesem Lebensabschnitt statt. Auch Epilepsien und Migräne (mit/ohne Aura) treten häufig auf und sind teilweise von hormonellen Faktoren abhängig. Ischämische Insulte bei Frauen im reproduktiven Alter sind dagegen selten und werden überwiegend durch bereits bestehende Risikofaktoren wie Hypercholesterinämie, arterielle Hypertonie, Nikotinkonsum und Diabetes mellitus begünstigt. Im Rahmen der Kontrazeptionsberatung sollte für die Betroffene jeweils ein individuelles Konzept erarbeitet werden. Dabei ist insbesondere auf begleitende Risikofaktoren und Arzneimittelinteraktionen einzugehen. Darüber hinaus muss auch die Effizienz der Kontrazeption vorab beurteilt werden, um bei gleichzeitiger Einnahme möglicher teratogener Substanzen einen ausreichenden Schutz zu gewährleisten.

Abstract

Neurologic diseases are prevalent among women of reproductive age. For instance, the peak age of onset of multiple sclerosis is during childbearing years. Additionally, epilepsy and migraine (with and without aura) affect many women and are sometimes even triggered by steroid hormones. Contrastingly, ischemic strokes are rare events during the reproductive years and are facilitated by preexisting risk factors such as hypercholesterinemia, hypertension, smoking, and diabetes. Women with preexisting neurologic diseases require individual differentiated contraceptive counseling. Preexisting risk factors have to be considered, as do interactions between hormonal contraceptives and disease-modifying drugs. Efficacy is another important issue for safe contraception, especially if women are on disease-modifying therapies with teratogenic risks.

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Correspondence to PD Dr. Sabine Segerer.

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Interessenkonflikt

S. Segerer und C. Keck geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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T. Strowitzki, Heidelberg

B. Sonntag, Hamburg

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Segerer, S., Keck, C. Differenzierte Kontrazeptionsberatung bei neurologischen Grunderkrankungen. Gynäkologe 52, 107–111 (2019). https://doi.org/10.1007/s00129-018-4353-y

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Schlüsselwörter

  • Kontrazeption
  • Multiple Sklerose
  • Epilepsie
  • Migräne
  • Ischämischer Insult

Keywords

  • Contraception
  • Multiple sclerosis
  • Epilepsy
  • Migraine
  • Ischemic stroke