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Hypercholesterolaemia - familial - Management
What special considerations are there for women and girls?
Pregnancy and breastfeeding
- Although there is no reason to advise against pregnancy or breastfeeding, inform all women and girls of childbearing age with familial hypercholesterolaemia (FH) that:
- Because lipid-lowering medication may increase the risk of fetal malformation if taken during the first trimester:
- They should stop lipid-lowering medication 3 months before attempting to conceive.
- In the event of an unplanned pregnancy, they should immediately stop lipid-lowering medication and seek medical advice.
- If the woman is considering pregnancy or is pregnant, refer her for pre-pregnancy planning and antenatal care by an obstetrician and, if she is not already under their care, a specialist with expertise in FH and a cardiologist.
- In the event of an unplanned pregnancy in a woman taking lipid-lowering medication:
- Refer urgently (to be seen within 14 days) to an obstetrician for fetal assessment.
- Avoid lipid-lowering medication, except bile acid sequestrants (resins), during lactation.
Contraception
- Although combined oral contraceptives (COCs) are not contraindicated, other methods of contraception should be considered because of the potential increased risk of cardiovascular events with COC use.
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