You will have to think carefully about what contraception you use after you have your baby.
- The only methods of contraception that are likely to cause problems for women who have had ICP are those containing hormones. However, there have been no large studies regarding the use of contraception following an ICP pregnancy, so you may be given conflicting advice about what you can or can’t use. Given that it has yet to be established whether it is progesterone or estrogen that ‘triggers’ the condition, it may be prudent to use only those hormonal forms of contraception that bypass the liver, such as the Mirena® coil (but see the comments about this below).
- However, anecdotal (not medically proven) evidence is showing that many women can tolerate the mini pill and some women are also able to use a low dose combined oral contraceptive pill. If you do decide to take the pill (the decision should be made in consultation with a doctor) it is important to make sure make sure that your liver function is normal before you begin. It should also be checked again approximately six weeks later. This is easily checked by requesting a liver function test (blood test). If you start to itch after you begin to take the pill you should stop. However, this itching shouldn’t be confused with cyclical itching, which is something that some women experience after having ICP and can be linked to ovulation or the start of menstruation. This itching normally only lasts for a few days and disappears once ovulation has taken place or the woman’s period starts.
- It is worth noting that some women who have contacted us report being unable to tolerate any form of contraception that contains hormones, including the Mirena® coil. Of course there are other forms of contraception that you can use, and you may want to discuss these options with your GP, nurse, midwife or local family planning clinic.
- There are of course other methods of contraception that do not contain hormones. These can be found here.
Marschall HU. Management of intrahepatic cholestasis of pregnancy. Expert Rev Gastroenterol Hepatol 2015; 9(10): 1273–9. doi: 10.1586/17474124.2015.1083857