Article Text

Download PDFPDF
Contraception for women with systemic lupus erythematosus
  1. Kelly R Culwell1,
  2. Kathryn M Curtis2
  1. 1Assistant Professor and Director of Family Planning, Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, CA, USA
  2. 2Health Scientist, Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
  1. Correspondence to Dr Kelly R Culwell, Department of Obstetrics and Gynecology, University of California, Davis, 4860 Y Street, Suite 2500, Sacramento, CA 95819, USA; Kelly.culwell{at}ucdmc.ucdavis.edu

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Overview

Systemic lupus erythematosus (SLE) is an autoimmune disease of uncertain aetiology that can affect multiple organ systems. The disease is more prevalent in women, with a female:male ratio of about 10:1 in most studies. In some populations SLE incidence is highest in women of reproductive age, while in others the highest age-specific incidence rates in women are seen after age 40 years.1 Globally, reported estimated prevalence rates in women range from 35/100 000 in a white subpopulation in the UK2 to 694/100 000 in an African American subpopulation in the USA.3 In general, a higher disease burden is found in non-white subpopulations worldwide.

Unfortunately, despite the complications that an unintended pregnancy can cause for a woman with SLE, many women with SLE are not counselled regarding contraceptive use or are counselled against contraceptive use based on concerns that contraceptives will adversely affect their disease. A recent study found that among a cohort of women with SLE and at risk of unintended pregnancy, including many on teratogenic medications, 59% reported no contraceptive counselling within the past year and 53% relied solely on barrier contraceptive methods.4

Recommendations

In the 2009 update of the World Health Organization Medical Eligibility Criteria for Contraceptive Use (WHOMEC),5 SLE was included for the first time as a condition. Recommendations were made by a working group of global family planning experts on the safety of contraceptive method use by women with SLE, based on a systematic review of the evidence (Table 1).6 Each medical condition/contraceptive method combination is classified as …

View Full Text

Footnotes

  • Disclaimer The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

  • Funding None.

  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.

Linked Articles

  • Highlights from this issue
    British Medical Journal Publishing Group