Contraception in Autoimmune Diseases

Publication date: Available online 11 May 2019Source: Best Practice &Research Clinical Obstetrics &GynaecologyAuthor(s): Giuseppe Benagiano, Marisa Benagiano, Paola Bianchi, Mario Milco D’Elios, Ivo BrosensAbstractAutoimmune diseases (AIDs) affect women with a 2 - 1 ratio vs. men, suggesting that hormonal contraceptives play a role in their clinical course.Combined oral contraceptives have complex, sometimes contradictory, effects on AIDs; they can worsen the situation in women with Systemic Lupus Erythematosus and with Antiphospholipid Syndrome, condition in which they are contraindicated. Early studies indicated a positive effect on rheumatoid arthritis (RA), whereas more recent trials failed to do so, possibly because of the lowering of oestrogen content. Evidence on effects on Multiple Sclerosis (MS) is conflicting: risk may vary depending on the progestin used. Minor adverse effects may exist on Inflammatory Bowel Diseases and no significant effect was found on Autoimmune Thyroid Diseases. Women can become sensitised to sex hormones.Progestin-Only Contraceptives may be used, although copper-releasing Intra-Uterine Devices represent the best option.Finally, several Organisations have issued guidelines for contraceptive use in women with AIDs.
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research

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