Reproductive health

Because of the young age at onset and preponderance in women, many patients with systemic lupus erythematosus (SLE) will need specialized management of their reproductive health. While most women with SLE can successfully bear children, the potential hazards of SLE in pregnancy demand that these pregnancies be carefully planned to limit the risks of pregnancy loss, preterm birth, and disease flares. As fertility is not impaired in most women with SLE, effective contraception is required to enable sexually active, heterosexual women to avoid pregnancy when they either do not wish to conceive or are at high risk for pregnancy complications. SLE can also bring complexity to the management of menopausal symptoms. Fortunately, both the American College of Rheumatology and the European League Against Rheumatism have published guidelines for the management of reproductive health issues in women with rheumatic disease, as well as the management of rheumatic disease during pregnancy (Sammaritano et al., 2020; Andreoli et al., 2017; Gotestam Skorpen et al., 2016). With this guidance, more patients living with SLE will be able to fulfill their own reproductive goals.

Duke Scholars

Author Megan Elizabeth Bowles Clowse Medicine, Rheumatology and Immunology