The Impact of Wilson Disease on the Female Reproductive System.

IMPORTANCE

Wilson disease (WD) is a rare genetic disorder that results in an accumulation of excess copper and can severely impact quality of life through its effects on numerous organ systems. Less is understood, however, about how WD alters the female reproductive system, where its impact is suspected to be wide-ranging.

OBJECTIVE

To provide an overview of the impact of WD on various aspects of women's health, including menstruation, fertility, pregnancy, and menopause. Key considerations and recommendations for management are highlighted throughout.

EVIDENCE ACQUISITION: Articles were obtained through a literature search of PubMed and Google Scholar.

RESULTS

WD impacts multiple aspects of women's health. WD may lead to delayed menarche, amenorrhea, and decreased fertility. Timely treatment can largely diminish these effects. WD's neuropsychiatric and hepatic manifestations, along with its respective medical therapy, may lead to higher rates of sexual dysfunction. There are many safe contraceptive options available for patients with WD. Treatment should be continued throughout pregnancy, although there are no conclusive guidelines. The safety of breastfeeding in patients with WD is under-studied. Lastly, WD is not known to directly impact menopause.

CONCLUSIONS

Complete care of female patients with WD requires consideration of its impact on various stages of the reproductive lifespan. Thus, an interdisciplinary team is an important component of optimizing care. Primary research in the field remains limited, and further studies are necessary to advance evidence-based care.

RELEVANCE: This review highlights the latest evidence regarding how WD affects women's health, along with recommendations for best management.