PubMed · 10870605
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1999. Contraceptive sponge returns.. https://pubmed.ncbi.nlm.nih.gov/10870605/
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CONTRACEPTION: As in women who do not have a heart transplant, contraception is never perfect, irrespective of the method, intrauterine device (risk of infection), estrogens, progestogens. PREGNANCY: Besides the general effects also observed in all pregnant women, pregnancy in the heart transplant recipient also carries the risk of cytomegalovirus infection and preeclampsia. IMMUNOSUPPRESSION: Cyclosporin or azathioprine are generally indicated, depending on the individual risks. PREVENTION OF BONE DISEASE: Advice concerning diet and lifestyle should be given prior to transplantation in order to reduce the risk of osteoporosis and osteomalacia. Bone density, particularly of the femoral neck, is essential for screening. A rheumatology examination is also quite useful. CANCER: De novo cancer is favored by the use of antilymphocyte inductors. Most are breast cancers (mean delay 60 months); other gynecology cancers develop after about 50 months. The risk of recurrence in patients who had breast cancer is highest during the first 2 years. The risk of recurrent uterine cancer is constantly observed.
Users of oral contraceptives have an increased risk of developing venous thromboembolism as well as mammary cancer. This raises the question as to whether locally applied (intrauterine) contraceptives can offer a valuable alternative with respect to efficiency and safety. During the past decade the use of modern intrauterine devices (IUDs) has made substantial progress in comparison with the use of IUDs during the 1970s and 1980s. Modern IUDs have become more efficient than oral contraception. Arguments against the use of IUDs (problems and complications in IUD insertion, the risk of pelvic inflammatory disease, ectopic pregnancy and infertility as well as side effects such as menorrhagia, pelvic cramps and IUD expulsion) generally appear to be based on a lack of awareness with respect to recent developments and on misunderstandings derived from bad experiences during the 1980s and earlier.
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