Contraceptive Pearl: Multiple Sclerosis and Contraception

Multiple sclerosis (MS), a degenerative neurologic disorder, often begins in early adulthood. The illness itself does not complicate pregnancy or affect contraceptive choice. 

Some MS patients take anticonvulsant medications, which may cause birth defects and interact with several hormonal birth control methods. Estrogen-containing methods and progestin-only pills are especially problematic for people treated with antiepileptic medications. (For details, see the Contraceptive Pearl on anticonvulsants). 

Pregnancy and breastfeeding seem to lower the risk of MS flares. Pregnancy is associated with a decreased risk of demyelinating events. However, MS treatment options are limited during pregnancy and lactation. These factors complicate reproductive decisions for MS patients, making preconception and contraceptive counseling particularly important. 

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Helpful Resources

Medical Eligibility for Initiating Contraception


Thone J, Thiel S, Gold R, Hellwig K. Treatment of multiple sclerosis during pregnancy — safety considerations. Expert Opinion on Drug Safety. 2017; 16(5):523-234. doi:10.1080/14740338.2017.

Ponsonby AL, Lucas RM, Van der mei IA Offspring number, pregnancy, and risk of a first clinical demyelinating event: the Ausimmune Study. Neurology. 2012;78(12):867-74. 


The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.