Doctors have often been hesitant to prescribe oral contraceptives to lupus patients for fear it might increase disease activity. In a major study funded by the National Institutes of Health, however, women with either inactive or stable systemic lupus were able to take "the pill"without increased risk of flares (periods of increased disease activity) that characterize the disease.
In the 15-center study of 183 women with inactive or stable lupus, those taking oral contraceptives had no significant difference in the occurrence of flares, compared with those taking a placebo. Severe flares occurred in about 7% of women, whether or not they were taking the pill. Mild-to-moderate flares were also similar between the 2 groups over the 12-month follow-up period.
Reluctance to prescribe the pill and other hormones to women with lupus arose partly due to the fact that lupus is more common in women than men (with a 10 to 1 ratio), and that it usually sets in during childbearing years, when a woman's hormones are at their peak. Past models showed that administering estrogen made the disease worse, but, for most women with moderate lupus, taking estrogen in most forms appears to have no negative effect on the disease.
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