People with CF have unique concerns related to sexual and reproductive health. These include questions about the following topics and more:
Puberty: In the past, people with CF often reported delayed puberty compared to their peers.
Menstrual periods: One in four adult females with CF report that their CF symptoms worsen during their menstrual cycle. Some females with CF may have absent or irregular periods associated with being underweight.
Urinary and fecal incontinence: Frequent coughing can weaken the pelvic floor muscles and lead to incontinence.
Vaginal health: The thickness and pH balance of vaginal secretions can be affected by a decrease in the number or abnormal function of cystic fibrosis transmembrane conductance regulator (CFTR) channels in the reproductive tract in females with CF. Use of antibiotics and medicines that contain steroids further change the levels of acidity and bacteria in the vagina, which can increase chances of yeast infections.
Testosterone deficiency: Prior research with adult and adolescent males with CF suggested that they have an increased risk for testosterone deficiency, also known as hypogonadism. The prevalence of hypogonadism in males on CFTR modulators is unknown but is an area of active investigation.
Sex and intimacy: Most people with CF enjoy an active sex life. However, some report frequent coughing during sex and other sexual functioning concerns. Use of sexual positions that put less stress on the lungs and pre-treating with airway clearance can decrease some of these symptoms. People with CF can prevent sexually transmitted infections and pregnancies by practicing safe sex.
Fertility and pregnancy: Most males with CF are infertile, though not sterile (they have sperm but are missing the tubes that carry sperm from the testicles). Most females with CF are fertile, though some have difficulty getting pregnant due to thick, pH imbalanced cervical mucus. As CFTR modulators thin cervical mucus, pregnancies have increased in females with CF. Researchers are looking into how modulators might affect fetal development. Males with CF can have biologic children through assisted reproductive technologies (ART) and research is planned to understand these experiences.
Parenthood: People with CF who become parents report challenges with balancing being a parent and having CF. Early research has shown that new parents with CF experience decreases in their lung function and health. Research is underway to better understand the health impacts of having CF and becoming a parent.
Menopause: More females with CF are reaching this milestone, but little is known how menopause might differ in people with CF relative to the general population. Research is being planned to investigate this topic.
Sex differences in CF: Females with CF historically have worse health outcomes, such as lower life expectancy and more pulmonary exacerbations, than males with CF. Researchers are trying to determine what factors (such as sex hormones) account for these differences.
Sexual orientation and gender identity: Research is underway to determine whether people with CF who are members of the LGBTQIA+ community have different health outcomes.