Contraception for antiphospholipid syndrome and systemic lupus erythematosus (according to the recommendations of the European Alliance of Associations for Rheumatology/American College of Rheumatology, EULAR/ACR)

Abstract

Maintaining and strengthening the health of the population is one of the primary functions of society. Inadequate understanding of the importance of contraception by the medical community and its application by society can lead to the population’s reproductive health becoming compromised. Basic knowledge of effective and safe contraceptive methods is important for every rheumatologist, as reproductive health affects both the general condition of patients and the course of the main rheumatic diseases (RH). This is particularly true for patients with antiphospholipid antibody (aPL) positivity, antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE). The presence of aPL/APS, as well as the activity of SLE, are the main factors determining the choice of contraceptive method and the risk of hormonal contraception in patients with RH. Meanwhile, the use of appropriate (highly effective and safe) contraceptive therapy in this category of patients allows not only to plan the birth of a child, but also to avoid unwanted pregnancy in cases of disease activity, the use of embryotoxic and teratogenic drugs, as well as to carry out optimal treatment of concomitant pathology, which the supervising rheumatologist should be well aware of. This publication is devoted to the consideration of the main issues of contraception in the most “vulnerable” category of patients with RH – with positive aPL, APS and SLE.