CF and Reproductive Issues

Siri Vaeth, M.S.W.

Reproductive health may be hard to talk about, but it is important that you get answers to your questions, safe from embarrassment. Ideally, your care team will ask you questions and provide information to draw you out. If not, it is important that you choose the person on your care team that you feel most comfortable with, and that you have time to share concerns or ask questions in private.

For teens with CF, puberty is often delayed. This may be due to nutritional challenges, as lower body weight is directly linked to delayed puberty. Boys with CF may find that their friends are growing taller and developing pubic and facial hair before them. It is very common for girls with CF to have their first period later than their peers without CF. Often, girls’ menstrual cycles are irregular.

Many teens with CF have questions about fertility. It is estimated that over 95% of men with CF have CBAVD (Congenital Bilateral Absence of the Vas Deferens).   While sperm is produced, the vas deferens tubes are blocked or absent, and no sperm is ejaculated with the semen. If you are a young man with CF you should not assume that you are infertile (meaning that males are unable to father a child without medical assistance; sterile means: inability to produce children). Until you are tested, you won’t know if you are part of the small percentage of men that have normal vas deferens. If you are part of the majority who have CBAVD, you should know that advances in medical technology have made it possible for men with CF to father biological children.

Young women with CF may have thicker cervical mucus that can inhibit pregnancy, but this should not be assumed. For sexually active teens with CF, birth control should be discussed with your doctor. For both young men and women, protection must be used to prevent sexually transmitted diseases (STDs). For female teens, CF can impact birth control options. For example, certain antibiotics may interfere with the effectiveness of oral contraceptives. It is important that your doctor knows if you are using birth control to ensure there is no negative interaction with your CF medications. As part of the transition process, your care team should give you an opportunity to speak privately, without your parent present.

Beyond reproductive questions, there are other issues that impact teens with CF but which may feel embarrassing to talk about. Many teenage girls with CF suffer with uncomfortable vaginal yeast infections caused by the antibiotics they are taking. This is very common and easily treatable. If you are experiencing this, let your doctor know. Additionally, many teens with CF - primarily girls - experience stress incontinence (put more plainly – wetting one’s pants) due to increased pressure on the bladder from chronic coughing. Many girls use pantyliners when they have an increased cough. There are also exercises that can help reduce these symptoms. If you ask your nurse or doctor (or whoever you feel most comfortable with), they can talk about these with you.

As teenagers, you are transitioning to take more control of your care. Finding a member of your care team to talk about the issues discussed above is key to your personal health.