Contraceptives in sickle cell disease.

Choosing the proper method of contraception for patients with sickle cell disease is an empiric exercise. In this manuscript, the commonly used contraceptive methods are examined for their risk-benefit ratio. However, because of its extensive use and effectiveness, steroid contraception is examined in greatest depth. Physiologic and pathologic changes induced by oral steroid contraceptives are evaluated, and their potential effects on patients with sickle cell disease are considered. Physiologic alterations evaluated are carbohydrate metabolism, blood lipid levels, hepatic function, thyroid function, and pigment changes. Pathologic changes reviewed are hypertension, thromboembolic phenomena, myocardial infarction, amenorrhea, and emotional changes. The choice of sterilization procedures is also considered for these patients.