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Related Experiment Video

Updated: Jan 24, 2026

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Contraception in autoimmune diseases.

Giuseppe Benagiano1, Marisa Benagiano2, Paola Bianchi3

  • 1Department of Obstetrics, Gynaecology and Urology, Policlinico Umberto I°, Sapienza University of Rome, Rome, Italy.

Best Practice & Research. Clinical Obstetrics & Gynaecology
|June 5, 2019
PubMed
Summary
This summary is machine-generated.

Hormonal contraceptives have varied effects on autoimmune diseases (AIDs). Combined oral contraceptives can worsen conditions like lupus, while progestin-only options or copper IUDs may be safer for women with AIDs.

Keywords:
Autoimmune diseasesHormonal contraceptionIntrauterine devicesMedical eligibility criteriaSteroid hormones

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Area of Science:

  • Immunology
  • Endocrinology
  • Gynecology

Background:

  • Autoimmune diseases (AIDs) disproportionately affect women (2:1 ratio), suggesting hormonal influences.
  • Hormonal contraceptives, particularly combined oral contraceptives (COCs), present complex and sometimes contradictory effects on the clinical course of AIDs.

Purpose of the Study:

  • To review the impact of hormonal contraceptives on various autoimmune diseases.
  • To provide guidance on contraceptive choices for women with AIDs.

Main Methods:

  • Literature review of studies examining hormonal contraceptive use in women with AIDs.
  • Analysis of evidence regarding combined oral contraceptives, progestin-only contraceptives, and intrauterine devices.

Main Results:

  • Combined oral contraceptives are contraindicated in systemic lupus erythematosus and anti-phospholipid syndrome.
  • Effects on rheumatoid arthritis (RA) are inconsistent, potentially due to decreasing estrogen content in newer formulations.
  • Evidence for multiple sclerosis (MS) is conflicting, with progestin type influencing risk.
  • Minor adverse effects noted in inflammatory bowel diseases; no significant impact on autoimmune thyroid diseases.

Conclusions:

  • Progestin-only contraceptives may be suitable, but copper-releasing intrauterine devices are often the preferred option for women with AIDs.
  • Guidelines for contraceptive use in women with AIDs have been established by various organizations.