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Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society, 22(2), 223-233, 2023

Sexual and reproductive health experiences and care of adult women with cystic fibrosis

Jennifer L. Taylor‐Cousar , Joanne Billings , Alana Fields

Author affiliations (13)
  • Jackson Memorial Hospital ROR
  • University of Minnesota ROR
  • Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
  • University of Washington, Box354982, 4311 11th Ave NE, Seattle WA 98105, United States. ROR
  • University of Pennsylvania ROR
  • Northwestern University ROR
  • The University of Texas Southwestern Medical Center ROR
  • Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, PA... ROR
  • School of Nursing, The University of Alabama at Birmingham, 1720 S. 2nd Ave., NB485-A, Birmingham, AL 35294, United States. ROR
  • Boston Children's Hospital ROR
  • University of Illinois-Chicago, 5001N. Wolcott Ave. #205 Chicago, IL 60640, United States. ROR
  • Baylor College of Medicine ROR
  • National Jewish Health, Denver, CO; 1400 Jackson Street, Denver, CO J318, United States.
DOI10.1016/j.jcf.2022.09.013 PMID36210323
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Abstract

Background

As survival and health improve in people with cystic fibrosis (CF), more women with CF (wwCF) are considering their sexual and reproductive health (SRH). This study compared SRH experiences, behaviors, and care utilization of wwCF to the general population and defined CF-impacted considerations and care preferences.

Methods

We surveyed wwCF aged ≥25 years regarding SRH and compared results to the US National Survey of Family Growth (NSFG;n = 4357) and friend controls(n = 123). We used descriptive statistics and chi-squared/Fisher's exact testing and linear regression for comparisons.

Results

A total of 460 wwCF (mean age 36.1 years) completed the survey. WwCF were less likely to report current contraceptive use (43%vs76% NSFG, p<0.001;60% friends, p = 0.005). Nearly 25% of wwCF reported worsened CF symptoms during their menstrual cycles, 50% experienced urinary incontinence, and 80% vulvovaginal candidiasis. WwCF were significantly less likely to be parents (46%vs62% friends, p = 0.015) and to have experienced pregnancy (37%vs78% NSFG, p<0.001;58% friends, p = 0.002). More wwCF required medical assistance to conceive (29%vs12% NSFG, p<0.001 and 5% friends, p<0.001). Eighty-four percent of wwCF view their CF doctor as their main physician and 41% report no primary care provider (vs19% friends; p<0.001). WwCF report suboptimal rates of contraceptive and preconception counseling/care and are less likely to have received HPV vaccination (42%vs55%friends, p = 0.02). Despite desiring SRH conversations with their CF team, <50% report discussing SRH topics.

Conclusion

WwCF have significantly different SRH experiences than non-CF peers. They report suboptimal SRH care compared to their preferences highlighting an urgent need to encourage SRH counseling/care in the CF model.

Topics

General OB/GYN > Reproductive Health > Chronic Disease PopulationsInfertility > Risk Factors > Cystic FibrosisGeneral OB/GYN > Preventive Care > Counseling and Education
cystic fibrosis women sexual reproductive health experiences, contraceptive use women with cystic fibrosis, cystic fibrosis fertility infertility medical assistance conception, menstrual cycle symptoms cystic fibrosis worsening, vulvovaginal candidiasis urinary incontinence cystic fibrosis women, preconception counseling chronic disease cystic fibrosis, Kazmerski cystic fibrosis reproductive health survey, HPV vaccination rates women chronic illness, cross-sectional survey reproductive health National Survey Family Growth comparison, CF care model sexual health counseling gaps, suboptimal gynecologic care chronic disease population
PMID 36210323 36210323 DOI 10.1016/j.jcf.2022.09.013 10.1016/j.jcf.2022.09.013

Cite this article

Kazmerski, T. M., Stransky, O. M., Lavage, D. R., Taylor-Cousar, J. L., Sawicki, G. S., Ladores, S. L., Godfrey, E. M., Aitken, M. L., Fields, A., Sufian, S., Jain, M., Barto, T. L., Billings, J., Hadjiliadis, D., & Jain, R. (2023). Sexual and reproductive health experiences and care of adult women with cystic fibrosis. *Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society*, *22*(2), 223-233. https://doi.org/10.1016/j.jcf.2022.09.013