[Gynecological management and follow-up in women with cystic fibrosis]

Abstract

Introduction: Most women with cystic fibrosis reach adulthood and should have appropriate gynecological follow-up and contraception.

Background: There is no specific contra-indication to any contraception due to cystic fibrosis itself. Combined estrogen-progesterone contraception can be used in most cases (including transplanted women). In case of transplantation, intra-uterine devices should be used carefully (risk of pelvic inflammatory disease, potential risk of contraceptive failure with copper intra-uterine devices). Hormonal contraceptives may not be effective in women taking corrective treatments aiming to correct the maturation defect of the chloride channel. Screening for cervical cancer is recommended with a pap smear every three years for women aged 25-65, but yearly and starting at a younger age among transplanted women who are at higher risk for cervical dysplasia. Human Papillomavirus vaccination should be offered to all young women.

Outlook: Women with cystic fibrosis and health care providers should be better informed on screening and on sexual and reproductive health to avoid unplanned pregnancies, to take into account drug interactions and to prevent cervical disease.

Conclusion: Regular and specific gynecological management is mandatory in cases of cystic fibrosis.

Keywords: Contraception; Cystic fibrosis; Dépistage; Gynecology; Gynécologie; Mucoviscidose; Screening.