How Arthritis Treatments Affect my Birth Control Choices

The last thing I ever expected my pediatric rheumatologist to bring up was sex. But as soon as I entered high school, it felt like that's all he ever wanted to talk about. Was I sexually active? Was I using reliable birth control? It was mortifying, especially in front of my mum. But I didn't realize at the time how important family planning is in deciding on treatment options for psoriatic arthritis.

It's so important that those using certain arthritis treatments use effective birth control. While there are medicines that are okay for use during conception and pregnancy, a few medications such as methotrexate can be harmful to a pregnancy. It's critical to talk to your rheumatologist about any plans to start a family, because it may influence your treatment plan.

My experience

When I first began using methotrexate as a young teen, I was advised not to get pregnant due to the risks involved. Once I entered high school, my doctor recommended that I keep condoms on hand, "just in case." He also advised that if I were to become regularly sexually active, to consider using the pill or an IUD.

Is One Enough?

But by the time I reached my eleventh-grade sex ed class, I began to wonder if just condoms or the pill was enough. Even after learning of various ways to prevent pregnancy, I still felt unsure. My teacher reassured us that many of the methods we learned about were reliable when used properly. But life isn't perfect. Pills can be forgotten, condoms can break, and ovulation timing can be tricky to get right.

And for that reason, my teacher highly recommended combining methods to reduce the risk of an unplanned pregnancy. While there is no 100% effective birth control other than abstinence, using two methods at once, such using the pill and condoms, does help reduce the risk of an unplanned pregnancy. Personally, I thought that sounded like a great idea for anyone avoiding pregnancy for a medical reason.

My choice

Years after finishing that health class, I still carry that bit of wisdom in my pocket. When there's a high risk that my medicine might affect a potential pregnancy, I'd rather not take too many chances. While one reliable method of birth control used responsibly is probably enough, it never hurts to have a backup.

Decisions, decisions

That said, there are no guarantees in life. Using two forms of birth control isn't 100% effective against pregnancy, it just makes it more unlikely. Besides that, it can be hard for some couples to find one method that works well for them- let alone two. The most important thing is to use at least one form of contraception consistently and properly- it can't work if you don't use it. Everyone is different, and what works for one may not work for another.

Peace of mind

At the end of the day, I know that one reliable method is probably enough. However, I like the peace of mind that comes with extra security. Knowing that there's a backup helps me feel more confident in both my sexual health and my arthritis treatment plan.