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Question answered:30/10/07 Warning! this question is over two years old.
The NLH Q&A Service have previously answered a question on Gilbert’s Syndrome and contraception [1]. Since then the Faculty of Sexual & Reproductive Healthcare have answered the question “For a woman with Gilbert’s syndrome, what are the available contraception options?” [2] which states:
“Gilbert’s disease is an asymptomatic liver disease where raised bilirubin is identified often incidentally. Low dose combined oral contraceptives (COCs) do not appear to have an effect on elevating bilirubin and some studies have in fact demonstrated a reduction in serum bilirubin with COC use. If COC is chosen as the method of contraception, monitoring of serum bilirubin in the first year of its use has been suggested. The CEU could not find any specific evidence concerning progestogen only methods but consider that these would be safe to use in women with Gilbert’s syndrome.”
However, as the cause of the raised bilirubin has not been ascertained we feel it is important that the cause is understood before looking for further information. To that end, you might be interested in the GP Notebook chapter “suggested protocol for investigation of a slightly raised isolated bilirubin in an asymptomatic patient in primary care”
References
1) http://www.clinicalanswers.nhs.uk/index.cfm?question=793
2) http://www.ffprhc.org.uk/admin/uploads/No1498.pdf
3) http://www.gpnotebook.co.uk/simplepage.cfm?ID=x20070406183836295600&linkID=70009&cook=yes
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