Answer to Monday's Question of the Day: Contraception for a patient w/ SLE

The question of contraception for a patient with SLE raises the issue of weighing benefits versus risks in a patient-centered context. First and foremost, pregnancy may be much riskier for this patient than any contraceptive, so it calls for a careful and thorough exploration of the patient's needs and the risks/benfits of various methods. As 2 students posted on the @OBGYNclerk twitter account, becasue a Mirena IUD is a progestin-only contraceptive, it may be the best alternative. In a recent article published in the August 2009 issue of Obstetrics & Gynecology, Dr. Culwell concludes: "Available evidence indicates that many women with SLE can be considered good candidates for most contraceptive methods, including hormonal contraceptives. The benefits of contraception for many women with SLE likely outweigh the risks of unintended pregnancy in this population. Women with positive antiphospholipid antibodies are not good candidates for combined hormonal contraception given their elevated baseline risk of thrombosis." You can read this article at: http://bit.ly/yr90D