John Libbey Eurotext

Médecine thérapeutique / Pédiatrie

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Chronic disease and gynecology. Example of cystic fibrosis Volume 21, issue 2, Avril-Mai-Juin 2018

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Authors
1 Hôpital des Enfants, Unité d’Endocrinologie et Gynécologie Médicale, Centre de Référence des Pathologies Gynécologiques Rares, 330 avenue de Grande Bretagne, TSA 70034, 31059 Toulouse Cedex 9, France
2 Hôpital Necker-Enfants Malades, Service d’endocrinologie, gynécologie et diabétologie pédiatrique, Centre de référence des pathologies gynécologiques rares, 149, rue de Sèvres, 75743 Paris Cedex 15, France
* Tirés à part
  • Key words: cystic fibrosis, puberty, menarchy, contraception
  • DOI : 10.1684/mtp.2018.0675
  • Page(s) : 129-35
  • Published in: 2018

All chronic diseases can interfere with gonadotropic regulation, pubertal development and menstrual cycle.

The choice of contraception will depend on the chronic disease, specific treatments of each pathology, drug against indications and drug interactions. For specific chronic diseases question of fertility will also arise.

Management of young girls with cystic fibrosis has been well optimized yet and life expectancy has increased significantly. Their body mass index is now normalized with the normality of nutritional status. Age at onset of menarche is comparable to that of the general population. Young girls with cystic fibrosis, such as those with another chronic disease, are often vulnerable girls, and gynecological care must be consider in the disease evolution. Fertility of women with cystic fibrosis is few altered.

As all teenagers with a chronic pathology they require an appropriate and effective contraception to prevent an unplanned pregnancy. All types of contraception can be discussed. The condom is always recommended and should be associated with hormonal contraception in the teenage girl. It's important to remind adolescents the protective role of condoms against all sexually transmitted infections and the importance of HPV vaccination.

It's necessary to incorporate gynecological follow up during overall care of chronic disease and to involve referential gynecologists.