Medicine Matters rheumatology

C is the correct answer. An intrauterine device can be offered to any SLE patient who is free of gynecologic contraindications. The use of combined hormonal methods has been shown to be safe in SLE patients with inactive or stable disease without aPL antibodies. Combined hormonal methods should be avoided in women with active disease and/or with aPL antibodies since they may increase the risk of disease flare and thromboembolic events. The thromboembolic risk associated with progestin-only pills (especially first-generation progestins) is much lower than that associated with estrogens, and so can be offered to selected patients with either active disease and/or positive aPL.

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