Question

What is the best method of contraception if you have ME?

My partner and I have a dilemma regarding our choice of contraception. I have mild to moderate ME/CFS. My husband is fit and well. We want to use a safe and reliable method but we aren’t having much luck!

I had to give up using ‘the pill’ because of side-effects, including migraine-type headaches. So we are reluctantly using barrier protection. But this isn’t ideal when you are not wanting to have another baby for both health and practical reasons.

I’ve thought about using a coil but am worried about whether having a ‘foreign body’ inside could cause more problems with my immune system. I’m also worried about the risk of infection, having had a pelvic infection in the past.

There doesn’t seem to be a simple solution and my GP isn’t very helpful when it comes to discussing the remaining options.

Answer

Firstly, there isn't a ‘recommended' method of contraception for people with ME/CFS.

Secondly, no method of contraception is contra-indicated in ME/CFS, including the various hormonal methods. However, there is one note of caution with ‘the pill'. One possible contra-indication here would be significant physical inactivity in someone with moderate or severe ME/CFS and the consequent risk of developing a blood clot/venous thrombosis.

If there is an increased risk of developing a pelvic infection – which would not be good news if you have ME/CFS – this would obviously have to be taken into account in relation to a coil

So couples have to weigh up the pros and cons of all the various methods according to degree of reliability, possible side-effects, their state of health, and any other medical conditions that are present, or have been present

If you are not getting the help you require from your GP I suggest you make an appointment with a family planning/contraception clinic – where staff have the experience and interest that will enable them to go through all the options, including the progestogen-only pill, which is another possibility.

You can go directly to a contraception clinic yourself (“self-referral”), or you can be referred by your GP. However, you may need to book an appointment to see a healthcare professional at a contraception clinic. You can ring the clinic first to find out. Many contraception clinics also have walk-in clinics, where you can turn up on the day and wait for an appointment.

Dr Charles Shepherd – Hon Medical Adviser, MEA

Updated – September 2021