Autoimmune diseases (AIDs) affect women and men with a 2:1 ratio, which suggests that hormonal contraceptives play a role in their clinical course. Combined oral contraceptives have complex, sometimes contradictory, effects on AIDs; they can worsen the situation in women with systemic lupus erythematosus and with anti-phospholipid syndrome, conditions in which they are contraindicated. Early studies indicated a positive effect on rheumatoid arthritis (RA), whereas more recent trials failed to do so, possibly because of the lowering of oestrogen content. Evidence of effects on multiple sclerosis (MS) is conflicting: risk may vary depending on the progestin used. Minor adverse effects may exist on inflammatory bowel diseases, and no significant effect was found on autoimmune thyroid diseases. Women can become sensitised to sex hormones. Progestin-only contraceptives may be used, although copper-releasing intra-uterine devices represent the best option. Finally, several organisations have issued guidelines for contraceptive use in women with AIDs.

Contraception in autoimmune diseases / Benagiano, G.; Benagiano, M.; Bianchi, P.; D'Elios, M. M.; Brosens, I.. - In: BAILLIERE'S BEST PRACTICE & RESEARCH. CLINICAL OBSTETRICS & GYNAECOLOGY. - ISSN 1521-6934. - 60:(2019), pp. 111-123. [10.1016/j.bpobgyn.2019.05.003]

Contraception in autoimmune diseases

Bianchi P.
;
2019

Abstract

Autoimmune diseases (AIDs) affect women and men with a 2:1 ratio, which suggests that hormonal contraceptives play a role in their clinical course. Combined oral contraceptives have complex, sometimes contradictory, effects on AIDs; they can worsen the situation in women with systemic lupus erythematosus and with anti-phospholipid syndrome, conditions in which they are contraindicated. Early studies indicated a positive effect on rheumatoid arthritis (RA), whereas more recent trials failed to do so, possibly because of the lowering of oestrogen content. Evidence of effects on multiple sclerosis (MS) is conflicting: risk may vary depending on the progestin used. Minor adverse effects may exist on inflammatory bowel diseases, and no significant effect was found on autoimmune thyroid diseases. Women can become sensitised to sex hormones. Progestin-only contraceptives may be used, although copper-releasing intra-uterine devices represent the best option. Finally, several organisations have issued guidelines for contraceptive use in women with AIDs.
2019
autoimmune diseases; hormonal contraception; intrauterine devices; medical eligibility criteria; steroid hormones
01 Pubblicazione su rivista::01a Articolo in rivista
Contraception in autoimmune diseases / Benagiano, G.; Benagiano, M.; Bianchi, P.; D'Elios, M. M.; Brosens, I.. - In: BAILLIERE'S BEST PRACTICE & RESEARCH. CLINICAL OBSTETRICS & GYNAECOLOGY. - ISSN 1521-6934. - 60:(2019), pp. 111-123. [10.1016/j.bpobgyn.2019.05.003]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1349211
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