Medicine Matters rheumatology

a. She may adopt any measure she feels more comfortable with, as there are no particular differences compared to the general population.

b. As the patient has SLE, independently of disease activity or aPL profile, she should never use hormonal pills or devices due to the risk of flare/increased disease activity.           

c. She should be advised to avoid combined hormonal methods (oral pills, vaginal ring, transdermal patch) because of increased risk for thrombosis due to high risk aPL profile. The use of progestin-only methods (pill or subcutaneous depot injections) should be weighed against the individual risk for thrombosis. An intrauterine device (either copper or levonorgestrel-releasing) would be the preferred option.

d. She should avoid combined hormone pills/devices, but progestin-only compounds are safe in the presence of aPL antibodies if no previous history of arterial or venous thrombosis.

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