Contraception With An Ostomy

Every situation is different, but you may not have to change much about your current contraception or family planning methods. Here’s what you need to know

Learn about the impact of a stoma on contraception.

Are you sexually active and concerned about your ostomy’s impact on contraceptives or family planning? Well, it may not have much impact at all. Most contraceptives are equally effective for people with and without stomas. Any of the common methods are possible— condoms, barriers (e.g. the cap, an intrauterine device), the pill or an injection.  Men may have vasectomies as a permanent means of family planning.

It is important to consider certain factors, however, depending on your situation.  

The pill and ileostomies: There is some evidence that birth control pills may be less effective for people with ileostomies (a stoma in the small intestine), since absorption may be unreliable.  The theory is that the medication passes through the digestive system very quickly without being fully absorbed into the body, which may decrease its effectiveness. You might need to have your dosage adjusted if your small bowel is not absorbing the medication well. Or, you may need to consider other methods of hormonal contraception, such as injections (e.g. progesterone) or a birth control patch. Talk to your healthcare professional or your family planning clinic to find the birth control method most effective for you.

Surgical changes: Some types of stoma surgery alter the anatomy of the vagina and uterus. Because of this, diaphragms, caps, intrauterine devices (IUDs) or coils may not be a good choice anymore. That’s because insertion and retention may be difficult. Ask your surgeon if there have been any changes to your anatomy that might impact contraception.

Condoms: These are an effective alternative for those having difficulty using other contraception methods. Condoms are highly reliable, provided they are used correctly and consistently.

Sterilisation: If you and your partner have made a final decision not to have children, then sterilisation is an option. Men can choose to have a vasectomy. Women can usually get a laparoscopic procedure that uses a tiny camera to view the inside of the abdomen. However, if you’ve had extensive abdominal surgery, you might have to get a laparotomy (which involves surgically cutting open the abdomen). This is because there may be a higher risk of a laparoscope perforating your intestine. Your sterilisation options should be discussed with your healthcare professional.

Your healthcare professional is always the best person to talk to when considering your best, most effective method of contraception.

Download the full pdf: Living with an Ostomy: Sex & Parenthood