Hormonal Contraceptives for Inflammatory Bowel Disease

AO
CS
Overseen ByCorinne Sexsmith
Age: 18 - 65
Sex: Female
Trial Phase: Academic
Sponsor: University of Utah
Must be taking: Hormonal contraception
Stay on Your Current MedsYou can continue your current medications while participating
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines how hormonal contraceptives might assist women with inflammatory bowel disease (IBD) who experience menstrual-related symptoms such as abdominal pain, diarrhea, and fatigue. Researchers aim to determine if hormonal contraception, like the levonorgestrel IUD (LNG IUD) or etonogestrel implant (ENG Implant), can alleviate these symptoms. Women with IBD and regular menstrual cycles, regardless of their use of hormonal contraception, may qualify for this study. Participants will provide essential data through surveys and samples, aiding future research on managing IBD symptoms. As an unphased trial, this study offers participants the chance to contribute to groundbreaking research that could enhance symptom management for many women with IBD.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, if you are using hormonal contraception, you should not start, stop, or switch methods during the 12-week study.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that hormonal birth control methods like the etonogestrel implant (ENG) and the levonorgestrel intrauterine device (LNG IUD) are generally safe for people with inflammatory bowel disease (IBD). Studies have found these methods to be highly effective at preventing pregnancy and safe for those with IBD. Only 5% of users reported worsening symptoms, indicating these methods are usually well-tolerated.

For the ENG implant, research supports its use without restrictions for people with IBD. However, some studies noted a slightly higher risk of infections in individuals with weakened immune systems, though these cases are rare.

The LNG IUD also carries a low risk of complications. Issues like pelvic inflammatory disease, an infection of the female reproductive organs, occur in less than 1% of users, regardless of age. This suggests that both the ENG implant and LNG IUD are safe options for managing IBD symptoms related to menstrual cycles.12345

Why are researchers excited about this trial?

Researchers are excited about using hormonal contraceptives like the ENG implant and LNG IUD for inflammatory bowel disease (IBD) because these treatments could offer a dual benefit. Unlike standard IBD treatments that focus on reducing inflammation through medications like corticosteroids or biologics, these hormonal methods may help manage symptoms by stabilizing hormonal fluctuations that could affect disease activity. The ENG implant and LNG IUD are already well-known for their effectiveness and convenience as contraceptives, providing long-term and reliable options without daily dosing, which could also improve quality of life for people with IBD.

What evidence suggests that hormonal contraceptives might be an effective treatment for IBD symptoms?

Research has shown that hormonal birth control might alleviate period-related symptoms in women with inflammatory bowel disease (IBD). In one study, 47% of women using the levonorgestrel intrauterine device (LNG IUD) reported improvement in their IBD symptoms during their menstrual cycle. Similarly, 19% of women using estrogen-based birth control felt better. Only about 5% of women using hormonal methods experienced worsening symptoms. This trial will compare naturally cycling participants with those using hormonal contraception, including options like the LNG IUD and etonogestrel (ENG) implants, to assess their impact on period-related IBD symptoms. While more research is needed, these early findings offer promise for those seeking relief from these symptoms.12678

Who Is on the Research Team?

Lori Gawron, MD, MPH – UTAH ...

Lori Gawron, MD

Principal Investigator

University of Utah

Are You a Good Fit for This Trial?

This trial is for premenopausal women with inflammatory bowel disease (IBD) who experience cyclical IBD symptoms related to their menstrual cycle. Participants should be between 18-45 years old, have a regular menstrual cycle, and not be at risk of pregnancy or willing to use condoms. They must intend to use an ENG implant or LNG IUD for birth control and agree possibly being randomly assigned one.

Inclusion Criteria

Intend to use a LNG IUD or ENG implant and willing to consider randomization
Have a regular menstrual cycle (21-35 days)
Fluent in English and/or Spanish
See 3 more

Exclusion Criteria

Breastfeeding without resumption of 2 normal menses
History of intolerance/ side effects with ENG Implant/LNG IUD
Current pregnancy (+urine pregnancy test in clinic)
See 4 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks
1 visit (phone or in-person)

Enrollment and Baseline Assessment

Participants complete a phone screening, discuss study procedures, and complete an enrollment survey assessing sociodemographic and reproductive characteristics, IBD history, and menstrual cycle timing and symptoms.

1 week
1 visit (in-person or virtual)

Study Engagement

Participants engage in study activities including daily and weekly text message surveys, and a subset participate in blood draws and fecal sample collection for inflammatory markers.

12 weeks
Weekly virtual surveys, monthly in-person visits for subset

Follow-up

Participants are monitored for changes in IBD PRO responses and inflammatory markers, and their willingness to be randomized in future trials is assessed.

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • ENG Implant
  • LNG IUD
Trial Overview The study tests if the ENG contraceptive implant or LNG intrauterine device (IUD) can alleviate cyclical IBD symptoms associated with menstruation. It's a pilot randomized controlled trial that includes daily/weekly surveys, blood draws, and fecal samples over approximately 8 months.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Naturally cycling participantsExperimental Treatment3 Interventions
Group II: Hormonal contraception usersActive Control3 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Utah

Lead Sponsor

Trials
1,169
Recruited
1,623,000+

Citations

The Impact of Hormonal Contraception on Disease-related ...Symptomatic improvement in cyclical IBD symptoms was reported by 19% of estrogen-based contraceptive users and 47% of levonorgestrel intrauterine device users.
Contraceptive use among women with inflammatory bowel ...Hormonal contraceptive use by women with inflammatory bowel disease (IBD) might affect risk of adverse outcomes or contraceptive effectiveness.
Fertility and Contraception in Women With Inflammatory ...IUDs and etonogestrel implants are highly effective and safe, and should be considered a first-line recommendation for patients with IBD. Benefits of ...
Family Planning for Patients With Inflammatory Bowel ...Research has found that only approximately half of people with IBD at risk of pregnancy received a prescription contraceptive, and use of highly effective, long ...
Hormonal Influences on Inflammatory Bowel DiseasesIn our previous cross-sectional study, 47% of the levonorgestrel intrauterine device users and 19% of combination oral contraceptive users ...
Etonogestrel contraceptive implant uptake and safety ...published data to date have demonstrated a higher rate of pelvic inflammatory disease or other. 232 pelvic infections among immunocompromised intrauterine ...
Global Consensus Statement on the Management of ...In women with inflammatory bowel disease who are pregnant or attempting conception, we suggest continuing maintenance thiopurine therapy as data ...
Family Planning for Patients With Inflammatory Bowel Disease ...All of these methods may be used without restrictions in IBD patients based on safety data. ... Etonogestrel implant. Progestin. Systemic.
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