Hormonal contraception in women with autoimmune diseases
A. Malutan, R. Ciortea, C. Porumb, R. M. Hognogi, C. Bucuri, A. Bobric, D. Clinciu, D. Mihu
Abstract: Hormonal contraception represents the contraceptive method of choice for the majority of women aged between 15 and 44 from developing countries. The majority of autoimmune diseases, especially rheumatologically ones, as systemic lupus erythematosus (SLE), rheumatoid arthritis, polymyositis or dermatomyositis, scleroderma or Sjogren syndrome, mainly affects the female population. Early counseling of these patients on the existing contraceptive methods is particularly important for several reasons: women with autoimmune diseases have the same infertility rate compared to healthy women; the treatments used for the basic disease can present adverse fetal effects; if pregnancy coincides with the disease remission, the odds for a healthy pregnancy and devoid of adverse events increases. Women with autoimmune diseases have the same need to choose a safe and efficient contraceptive method just like general population. Physicians should fully understand the advantages and disadvantages of each contraceptive method, the effect of various contraceptive methods in disease activity, health risks, and the possibility of interaction with other competing drugs as well as the couple’s preferences. Combined oral contraception is efficient, convenient and reversible. These have indication in most of autoimmune pathologies including SLE, outside of flares, in the absence of antiphospholipid syndrome or other thrombotic risk factors. In this review, we tried to summarize the instructions for using hormonal contraception by women at reproductive age, affected by one of the main autoimmune diseases, conditions with an important component in young female population.
DOI:10.18643/gieu.2015.141