Doctors have often been hesitant toprescribe oral contraceptives to lupuspatients for fear it might increase diseaseactivity. In a major study fundedby the National Institutes of Health,however, women with either inactiveor stable systemic lupus were able totake "the pill"without increased risk offlares (periods of increased diseaseactivity) that characterize the disease.
In the 15-center study of 183 womenwith inactive or stable lupus, those takingoral contraceptives had no significant differencein the occurrence of flares, comparedwith those taking a placebo.Severe flares occurred in about 7% ofwomen, whether or not they were takingthe pill. Mild-to-moderate flares werealso similar between the 2 groups overthe 12-month follow-up period.
Reluctance to prescribe the pill andother hormones to women with lupusarose partly due to the fact that lupusis more common in women than men(with a 10 to 1 ratio), and that it usuallysets in during childbearing years,when a woman's hormones are at theirpeak. Past models showed that administeringestrogen made the diseaseworse, but, for most women with moderatelupus, taking estrogen in mostforms appears to have no negativeeffect on the disease.