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Background <p>Multiple sclerosis (MS) predominantly affects women of reproductive age. Issues related to hormonal contraception and family planning are therefore highly relevant in clinical practice, particularly in the context of disease-modifying therapy (DMT).</p> Objective <p>Presentation of clinically relevant principles of contraceptive counselling in women with MS, with a&#xa0;particular focus on hormonal contraception in the context of DMT.</p> Material and methods <p>Narrative review based on the current literature and international recommendations on contraception and reproductive planning in MS.</p> Results <p>Hormonal contraceptives do not increase the risk of developing MS or adversely affect disease activity. The choice of method should be individualized, taking disease-specific factors such as mobility, risk of venous thromboembolism, cognitive impairment and adherence into account. Long-acting reversible contraceptives are particularly suitable due to their high efficacy and low user dependency. The DMTs differ substantially with respect to teratogenicity, required washout periods and effectiveness. While interferons and glatiramer acetate have favorable safety profiles, sphingosine-1-phosphate receptor modulators, teriflunomide and cladribine require reliable contraception. Treatment decisions must be closely aligned with individual reproductive planning.</p> Conclusion <p>Structured, interdisciplinary counselling involving neurologists and gynecologists is essential to prevent unintended pregnancies while enabling safe pregnancies through anticipatory treatment planning.</p>

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Hormonelle Kontrazeption bei Patientinnen mit multipler Sklerose – was müssen Gynäkolog:innen wissen?

  • 期刊论文

  • 发表日期：

    2026年5月29日

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  • Johanna Oechtering

摘要

Background

Multiple sclerosis (MS) predominantly affects women of reproductive age. Issues related to hormonal contraception and family planning are therefore highly relevant in clinical practice, particularly in the context of disease-modifying therapy (DMT).

Objective

Presentation of clinically relevant principles of contraceptive counselling in women with MS, with a particular focus on hormonal contraception in the context of DMT.

Material and methods

Narrative review based on the current literature and international recommendations on contraception and reproductive planning in MS.

Results

Hormonal contraceptives do not increase the risk of developing MS or adversely affect disease activity. The choice of method should be individualized, taking disease-specific factors such as mobility, risk of venous thromboembolism, cognitive impairment and adherence into account. Long-acting reversible contraceptives are particularly suitable due to their high efficacy and low user dependency. The DMTs differ substantially with respect to teratogenicity, required washout periods and effectiveness. While interferons and glatiramer acetate have favorable safety profiles, sphingosine-1-phosphate receptor modulators, teriflunomide and cladribine require reliable contraception. Treatment decisions must be closely aligned with individual reproductive planning.

Conclusion

Structured, interdisciplinary counselling involving neurologists and gynecologists is essential to prevent unintended pregnancies while enabling safe pregnancies through anticipatory treatment planning.