Lupus and birth control options: Determining safety considerations.
People with lupus, an autoimmune condition that can cause symptoms such as muscle and joint pain, fever, and rashes, may need to consider the impact of birth control on their health. Here's a guide to help navigate the options.
Firstly, combined estrogen-progestin contraceptives, such as the combined pill, patch, or ring, should be avoided due to an increased risk of blood clots, especially in lupus patients with antiphospholipid syndrome or positive antibodies linked to clotting (anticardiolipin, lupus anticoagulant).
Instead, safer and effective birth control methods for lupus patients include non-hormonal options like the copper intrauterine device (IUD) and hormonal methods that do not contain estrogen, such as progestin-only pills, progestin implants, depot medroxyprogesterone acetate injections, and levonorgestrel-releasing IUDs. The copper IUD is safe for all lupus patients and a highly effective non-hormonal method.
The levonorgestrel IUD, progestin-only pills, implants, and depot medroxyprogesterone acetate are effective hormonal options with a lower clot risk. However, the levonorgestrel IUD should be used cautiously when thrombosis risk is present.
Women with active lupus or moderate-to-high disease activity should preferentially use non-estrogen contraceptives due to potential clotting and disease exacerbation concerns. Testing for antiphospholipid antibodies is recommended before prescribing hormonal contraception to assess thrombotic risk.
Counseling on risks and benefits should be individualized and involve rheumatology and gynecology experts.
It's important to note that progestin-only birth control is generally safe for people with lupus. Some individuals with lupus are at a higher risk of developing blood clots, so they should avoid certain options.
The IUD, both copper and levonorgestrel, can last up to 10 years and 3-5 years respectively, making them long-term, reliable solutions. Lupus can complicate pregnancy, so many individuals with lupus choose to take birth control. With the right support, it is possible to find a comfortable and effective birth control option for individuals with lupus.
Barrier methods, including male and female condoms, vaginal sponges, cervical caps, and diaphragms, are safe for individuals with lupus but are less effective than other methods.
In the United States, 18-24% of pregnancies occur each year using a barrier method. In contrast, IUDs effectively prevent pregnancy more than 99% of the time.
In conclusion, the safest and most effective birth control methods for people with lupus focus on non-estrogen hormonal methods and non-hormonal IUDs, while combined estrogen-progestin methods should be avoided whenever clotting risk is elevated.
- Due to the increased risk of blood clots, combined estrogen-progestin contraceptives should be avoided by lupus patients, especially those with antiphospholipid syndrome or positive antibodies linked to clotting.
- Safe and effective birth control methods for lupus patients include the copper IUD, progestin-only pills, progestin implants, depot medroxyprogesterone acetate injections, and levonorgestrel-releasing IUDs.
- Women with active lupus or moderate-to-high disease activity should preferred non-estrogen contraceptives due to potential clotting and disease exacerbation concerns.
- The IUD, both copper and levonorgestrel, are long-term, reliable solutions that can last up to 10 years and 3-5 years respectively.
- Progestin-only birth control is generally safe for people with lupus, but some individuals might be at a higher risk of developing blood clots and should avoid certain options, compared to non-hormonal IUDs.
