Contraception: “Research evaluating contraceptive safety has focused primarily on SLE, RA and APS, but most [contraceptive] methods appear to be safe for women with other rheumatic diseases,” write the authors.
The reviewers emphasize the importance of contraceptive counseling in family planning, outlining the common side effects for patients with rheumatic disease, efficacy and reversibility of multiple methods. Although method selection should be guided by a patient’s individual preferences, women with chronic diseases who have an increased risk of pregnancy complications may consider contraceptive efficacy particularly important.
According to research, progestin-only subdermal implants are the most effective contraceptives available (first-year failure rate 0.05%). But long-acting reversible contraceptives, such as intrauterine devices (IUDs), are also highly effective for preventing pregnancy.
“To benefit all rheumatic disease patients, providers may expand their competencies to provide patient-centered, respectful and comprehensive family planning counseling,” write the authors in their conclusion. “Education in family planning and patient-centered communication should be incorporated into specialty and subspecialty training. Through enhanced attention to family planning, we can empower individuals with rheumatic diseases to make important decisions to improve their health, and the well-being of their children and families.”
Birru Talabi M, Clowse MEB, Schwarz EB, et al. Family planning counseling for women with rheumatic diseases. Arthritis Care Res (Hoboken). 2018 Feb;70(2):169–174. doi: 10.1002/acr.23267.