Contraception in case of CF with diabetes

Question

Dear expert team,
I (22 years old, CF) have a few general questions, that could either not be answered satisfactorily by my gynaecologist nor by my CF-doctor.
1. Which contraceptional method is the one most suitable in case of a CF patient with induced diabetes- except condom? Also in respect of the frequent intake of antibiotics, as well as at the moment itraconazole against candida.
2. Until now, I am taking the pill (Cerazette®, 75µg, contains only gestagens, so called "mini-pill")) and have rather been quite satisfied with it. My BMI is 16, I did not have my menstruation for about 2 years now. Due to the low BMI I however do not know, if this is due to the pill or to the underweight. Furhtermore, I do have bleedings since some days. What is the reason?
Due to my health condition (FEV below 30%) by no means I should become pregnant. Due to the diabetes I am not allowed to take a "normal" pill (problems due to the contained hormones).
I ask you for a quick answer, as I am at my wits' end with those questions.
Many thanks in advance.
Best regards,

Answer

Dear questioner,
Cerazette® is certainly a good idea in your situation and has in general no interactions with the diverse antibiotic drugs. Taking it without pause Cerazette® inhibits the menstruation in the long runs, why you have a bleeding now you should discuss with your gynecologist.
Alternatively, one could also use the hormone coil Mirena®, which also shows good efficacy and also prevents inflammations of the tubes.
In case you do not yet have any long-term damages due to your diabetes resp. it does not exist longer than 20 years, you are quite allowed to take a normal pill with estrogens and gestagens (according to WHO).
That you did not have a menstruation for 2 years now, can be due to your BMI or due to the Cerazette®, that cannot be answered retrospectively.
I hope that I have been able to help you with that.
Best regards,
Dr. Anja-Undine Stücker

21.01.2013