Contraception for women with rheumatologic disease

Kelly R. Culwell, Geraldine M. Navarro

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are two of the most common rheumatologic diseases diagnosed in women. Both SLE and RA frequently start in women of reproductive age and have significant implications for pregnancy. Use of contraceptive methods in these conditions has been controversial in the past due to concerns regarding potential worsening of disease activity, increased risk for cardiovascular complications, or infection with certain methods in the setting of immunosuppressive treatment. The primary risks from use of hormonal contraceptives in women with SLE involve thrombogenic risks, particularly in those women with positive antiphospholipid antibodies. The best available evidence does not indicate a risk of worsening disease activity in women with inactive or stable active SLE who use hormonal contraceptives. Therefore, with the exception of women at increased risk for thrombosis due to the presence of antiphospholipid antibodies, the benefits of contraception outweigh the risks for most women with SLE. All contraceptive methods appear safe for most women with RA, with the exception of use of progestin-only injectables in women with the greatest risk of osteoporosis. Overall, risks of contraceptive use in women with rheumatologic diseases must be weighed against the risks of unplanned pregnancy during a period of severe disease activity or while on teratogenic medications.

Original languageEnglish (US)
Title of host publicationContraception for the Medically Challenging Patient
PublisherSpringer New York
Pages307-320
Number of pages14
ISBN (Electronic)9781493912339
ISBN (Print)9781493912322
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Contraception
Systemic Lupus Erythematosus
Contraceptive Agents
Rheumatoid Arthritis
Antiphospholipid Antibodies
Unplanned Pregnancy
Progestins
Immunosuppressive Agents
Osteoporosis
Thrombosis
Pregnancy
Injections
Infection

ASJC Scopus subject areas

  • Health Professions(all)
  • Medicine(all)

Cite this

Culwell, K. R., & Navarro, G. M. (2014). Contraception for women with rheumatologic disease. In Contraception for the Medically Challenging Patient (pp. 307-320). Springer New York. https://doi.org/10.1007/978-1-4939-1233-9_17

Contraception for women with rheumatologic disease. / Culwell, Kelly R.; Navarro, Geraldine M.

Contraception for the Medically Challenging Patient. Springer New York, 2014. p. 307-320.

Research output: Chapter in Book/Report/Conference proceedingChapter

Culwell, KR & Navarro, GM 2014, Contraception for women with rheumatologic disease. in Contraception for the Medically Challenging Patient. Springer New York, pp. 307-320. https://doi.org/10.1007/978-1-4939-1233-9_17
Culwell KR, Navarro GM. Contraception for women with rheumatologic disease. In Contraception for the Medically Challenging Patient. Springer New York. 2014. p. 307-320 https://doi.org/10.1007/978-1-4939-1233-9_17
Culwell, Kelly R. ; Navarro, Geraldine M. / Contraception for women with rheumatologic disease. Contraception for the Medically Challenging Patient. Springer New York, 2014. pp. 307-320
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