Comparing female‐based contraceptive methods in patients with systemic lupus erythematosus, rheumatoid arthritis and a healthy population

Abstract

Aim: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that is 10 times more prevalent in women, particularly those of reproductive age. The varying effects of pregnancy on SLE and the differences between available SLE treatments make pregnancy timing and contraceptive methods significant. We aimed to determine the contraceptive methods used by SLE patients in the north-west part of Turkey, and compared them with those used by rheumatoid arthritis (RA) patients and healthy controls. Method:The study was comprised of 113 SLE patients, and 84 RA patients at the Rheumatology Outpatient Clinic of Uludag University Medical Faculty.Results: Twenty-three (20.3%) out of 113 SLE patients, 18 (21.4%) out of 84 RA patients and 17 (18.6%) out of 92 healthy controls did not use any contraceptive methods. Use of the withdrawal and condom methods was more common among SLE patients, accounting for 61% (withdrawal 32.7%, condom 28.3%). Moreover, 52% of SLE and 50% of RA patients were neither given information about contraceptive methods nor offered a suggested method, compared to 34% in the health control group. Conclusions:The prevalence of oral contraceptive use is low in Turkey; notwithstanding the withdrawal and condom methods, which are frequently used despite their high failure risk. Although pregnancy timing is of great importance for SLE patients, necessary information and recommendations concerning contraceptive methods have been ignored and the use of effective methods is not a priority.

Pregnancy outcomes and contraceptive use in patients with systemic lupus Erythematosus, rheumatoid arthritis and women without a chronic illness: a comparative study

“…These findings on contraceptive prevalence were consistent with the findings of a cross‐sectional study among SLE patients in Finland where contraceptive use was 59% in SLE patients compared to 77% in the general population . However, our results are in contrast to Dalkilic et al . reporting contraceptive usage of 80%, 79% and 81%, respectively in SLE, RA and a healthy population in Turkey.…”

Contraceptive Prevalence and Consulting Service in Women with Systemic Lupus Erythematosus: A Cross-Sectional Study

“…In the current study, 35.2% of the patients with SLE received contraceptive consultations in the last year which shows a relatively lower rate compared to other studies ( 8 , 9 , 15 , 16 ). A study in Brazil found that among 85 women with SLE, 53% did not use any contraceptive method but 22% used condoms, 11% used combined oral contraceptives and 7% used hormone injections ( 9 ).…”

“…A study in Brazil found that among 85 women with SLE, 53% did not use any contraceptive method but 22% used condoms, 11% used combined oral contraceptives and 7% used hormone injections ( 9 ). In another study in Turkey, 20.3% of SLE patients did not use any contraceptive methods, but using withdrawal and condom were found to be more common (withdrawal 32.7%, condom 28.3%) ( 16 ). According to Cravioto et al discontinuation rate for different methods of contraception is significantly different; 35% in OCP, 55% in progestin-only pills (POP), and 29% in IUD ( 17 ).…”

A systematic review of interventions to improve knowledge and self-management skills concerning contraception, pregnancy and breastfeeding in people with rheumatoid arthritis

“…For example, a recent clinical audit of sexually active women with rheumatologic conditions including RA found that only 57% of women on known teratogenic DMARDs were using effective contraception despite receiving specialist rheumatology care at a large teaching hospital [49]. A hospital-based study in Turkey also highlighted suboptimal contraceptive use among female patients with RA [50]. Appropriate education and support should also be made available outside the clinical setting as information seeking may not coincide with the timing of clinical consultations.…”