Lupus and Birth Control Pills

Birth control pills are one of the most popular forms of contraception because of their convenience, but they’re not for everyone. For women with certain medical conditions, it may be safer to use an alternative form of birth control. What about women with lupus? Are lupus and birth control pills a safe combination?

Lupus and Birth Control Pills: Are They Safe?

Lupus is most common in women of child-bearing age, so it’s not surprising that women with this condition have questions about birth control and whether birth control pills are safe for them to take with this disease. Some studies show that women who use oral contraceptives, particularly higher dose ones, have a greater risk of getting lupus in the first place.

In the past, most doctors have recommended alternative forms of birth control for women with lupus due to concerns that the estrogen in these pills could make lupus symptoms worse. Some previous animal studies suggested that the estrogens in these pills worsen the symptoms of lupus, and one small human study showed that birth control pills contribute to lupus flare-ups. This study has since been questioned because the trials weren’t controlled and the participants already had underlying lupus-related kidney disease.

A Change in Thinking about Lupus and Birth Control Pills

More recently thinking about lupus and birth control pills has changed after two research trials showed that women with mild to moderate lupus that’s stable were at no increased risk for flare-ups when they took birth control pills.

This is good news for women with milder forms of lupus, but what about those with more severe symptoms? The consensus is that birth control pills may not be safe for women with more serious cases of lupus – and more research is needed before women should feel comfortable taking them if they fall into this category.

Around 35% of women with lupus test positive for a protein called anti-phospholipid antibody. This antibody increases the risk of blood clots, heart attack, and stroke. At the same time, the estrogens in birth control pills also elevate the risk of a blood clot, potentially making the combination of the two even more deadly. Most experts recommend that women be tested for anti-phospholipid antibodies before taking birth control pills – and if they’re present use other forms of contraception.

Lupus and Birth Control Pills: There are Some Benefits

There are some benefits to women with mild to moderate lupus who take birth control pills. Oral steroids such as prednisone are frequently used to control the symptoms of lupus, and one side effect of these medications is bone loss. Taking oral contraceptives helps to offset some of the loss of bone density that can lead to osteoporosis and bone fractures. Birth control pills also make it easier for women to avoid unwanted pregnancies, which could make lupus symptoms worse.

The Bottom Line

Lupus and birth control pills aren’t necessarily incompatible as long as a woman doesn’t have a severe case of lupus or anti-phospholipid antibodies. Of course, women with lupus should always talk to their doctors about the best form of birth control for their particular situation.

References

Medscape.com. “Oral Contraceptives Safe for Most Lupus Patients”

Medscape.com. “Data now support use of oral contraceptives in many lupus patients”

Web MD. “Birth Control Pills May Raise Lupus Risk”