Doctors Routinely Fail To Inform Women About An Anesthetic That Reduces The Efficacy Of Hormone Birth Control Methods

A wide range of contraceptives relies on the hormone progesterone for preventing pregnancies. Contraceptives like intrauterine devices, oral pills, vaginal rings, and implants work by releasing small amounts of progesterone for several months to years. Their typical failure rate ranges from only 0.1% to 7%, according to the Centers for Disease Control and Prevention.

Progesterone’s main mechanism of action is to prevent ovulation by inhibiting the secretion of follicle-stimulating hormone and luteinizing hormone in your blood. But for women who have undergone operations, the risk of their birth control method’s efficacy dropping is far higher, according to anesthetics who gave a presentation recently at the European Society of Anesthesiology and Intensive Care in Milan.

The drug sugammadex is commonly used in anesthesia for waking up patients once their surgery ends. It is known for its ability to undo the actions of drugs that are given prior to the surgery for muscle relaxation. Doctors are well aware of the fact that sugammadex cuts down the efficacy of hormonal contraceptives.

As of now, sugammadex is still expensive and can cost up to £59.74 for 2 mg/kg in a patient who weighs 75 kgs. But studies have found that the use of sugammadex can still be cost-effective because of its ability to reduce operative time and post-operative recovery. The drug also helps in preventing postoperative residual paralysis. It is well tolerated and does not cause any adverse drug reactions, according to a 2013 study published in the journal Anesthesia Essays and Researches.

The issue, the team of anesthetics found is that doctors fail to inform women who are undergoing surgeries about how sugammadex makes hormonal contraceptives far less effective than usual. If women of child-bearing age are informed of this risk, they can follow the missed pill advice and also use non-hormonal forms of contraceptives for a week.

At University College London, an anesthetic Dr. Neha Passi and colleagues surveyed close to 150 other anesthetics with seven questions to determine if they were informing their women patients about the common side-effects of sugammadex.

Out of the 150 professionals, only 82 anesthetics responded. Out of that, even though 94% of them were aware of the risk of hormonal contraceptives failing — thanks to sugammadex — only 30% of them said they routinely discuss this common side-effect with women of childbearing age.

During the six weeks duration when these surveys were carried out, 234 patients were administered sugammadex. From that, 48 women needed to be informed about the risks of contraceptive failure. However, none of them got any such advice, according to their medical notes.

“Use of sugammadex is expected to rise as it becomes cheaper in the future and ensuring that women receiving this medicine are aware it may increase their risk of unwanted pregnancy must be a priority,” said Passi in a press release. “It is concerning that we are so seldom informing patients of the risk of contraceptive failure following sugammadex use.”