[Systemic lupus erythematosus (SLE): sexual hormones, contraception and pregnancy]

Sexual hormones, particularly estrogens, appear to play a role in the development of SLE. Pregnancy as well as the use of exogenous sexual hormones prescribed as contraceptives, as substitutive therapy, or to induce ovulation can be associated with disease flares. However, pregnancy can be envisaged in SLE patients with well controlled disease, on the condition that medical follow-up is observed. To prevent fetal loss due to antiphospholipid syndrome prophylactic anticoagulation is required. The presence of maternal anti-SSA antibodies is an indication for a tight pregnancy follow-up for early detection of fetal cardiac conduction block. Finally, in the absence of antiphospholipid antibodies, oral contraception with low-dose estrogens and progestatives may be contemplated.