Until you achieve control of your T1DM and are officially ready to conceive (meaning that your doctor has given you the go-ahead), the wisest course of action is to use contraception. For purposes of contraception, the first day of your menstrual cycle is the first day of bleeding; between the 8th and 18th days, you're most fertile and likely to become pregnant if you have unprotected sex, so contraception is absolutely crucial during this time. You're most fertile for 24 hours before ovulation and a few hours after ovulation. You can determine ovulation by taking your body temperature. When it rises 0.2 degrees F and persists at that level, ovulation has occurred. If it rises again a few days later and persists, conception has likely occurred.
As a woman with T1DM, you have the same choices of contraception as a woman without diabetes. These include:
i Condoms, which also protect against sexually transmitted diseases.
i Contraceptive implants that are removable if necessary.
i Depot injections of progesterone. These may cause an increase in blood glucose and can't be removed until they're used up, which may take months, even if you experience side effects of nausea and increased appetite.
i Diaphragm and spermicidal jelly.
i Intrauterine device, which sometimes causes infections and loss of uterine function and therefore isn't used until after a first pregnancy.
i Minipills consisting of progesterone alone, which may increase spotting.
i Morning-after pills like Plan B, which must be taken within 72 hours of unprotected sex.
i Oral contraceptives, which are a combination of small doses of estrogen and progesterone, and not recommended for smokers, people with high blood pressure, or those who suffer from migraine headaches.
Oral contraceptives are the method of choice for younger women with T1DM, and an IUD is recommended for women with T1DM who have had a child.
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