The objective of this review was to make a critical appraisal of the current evidence about the safety of oral contraceptive use in patients with two autoimmune diseases: Systemic Lupus Erythematosus and Rheumatoid Arthritis. A Medline search for articles published until September 2006 regarding the relationship between oral contraceptives and these two diseases was performed. The incidence of both illnesses is far greater in women than in men and both appear most frequently during the reproductive stage of life. Pregnancy is not recommended when either of the diseases is active due to the fact that the outcome for both the fetus and the mother can be unfavorable. It has been suggested that conception should take place during a period of disease quiescence. Therefore, effective contraceptive methods are recommended in order to achieve pregnancy ideal conditions for both mother and fetus. Oral contraceptives, when taken under prescription, are among the most effective non-surgical method for contraception. Nevertheless retrospective and prospective studies have shown a deleterious effect on Systemic Lupus Erythematosus activity an increased risk of venous thrombosis associated with the use of exogenous estrogens. In the case of Rheumatoid Arthritis there is a lack of consensus in the literature regarding the association between oral contraceptives and the subsequent development of the disease or in the improvement of its symptoms. These discrepancies are due, at least in part, to significant methodological differences.
Keywords: Systemic Lupus Erythematosus, Rheumatoid arthritis, oral contraceptives, autoimmune disease, contraception, hormonal contraceptives
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