Drugs employed during pregnancy and contraceptive methods in rheumatic disease. New evidence

Voluntary birth control, the ability to identify the best moment for becoming pregnant depending on disease activity, and the need to avoid conception during the administration of teratogenic drugs are the main reasons for the use of contraceptive methods among women with rheumatic diseases. This article reviews the risks that antirheumatic drugs represent during conception, pregnancy and lactation and the contraceptive methods that are currently available to patients. Hormonal therapy has developed considerably and can further our understanding of safety aspects, especially for systemic lupus erythematosus patients. Recently the methods of administration have evolved, and now include transdermal and intravaginal routes, a progesterone-releasing intrauterine device, and an extended-cycle oral contraceptive. Rheumatologists work increasingly in conjunction with patients to assist in choices regarding contraceptive methods and pregnancy planning. Each decision should be individualized according to the personal preference and the stage of reproductive life. (C) 2008 Elsevier Espana, S.L. All rights reserved.