Birth Control, HRT and Lupus: The Debate Continues

Ines Martins, PhD avatar

by Ines Martins, PhD |

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My Mountain, My Lupus column
Unbeknownst to me, there is a debate raging in online forums — and it has nothing to do with politics. The debate has been going strong for more than 30 years regarding whether birth control and hormone replacement therapy (HRT) causes flare-ups in Lupus patients.

Most women are diagnosed with lupus in their child-bearing years. Conventional thought was that birth control and HRT, due to the estrogen in them, caused flare-ups. Where did these studies originate? And the more important question, Is it safe to use estrogen-based products if you have lupus?

Estrogen has a variety of uses

There are many reasons why estrogen would be added as a daily medication. Most commonly, it can be found in birth control as a contraceptive, or in HRT during menopause. It also can be used to shrink uterine and ovarian cysts, as well help control the flow of a woman’s menstrual cycle. There are many other uses, such as helping transgender women, prostrate cancer, breast cancer, and the list goes on. You can see a lot of people taking estrogen on a daily basis, and it’s not just for birth control. For decades we have been relying on research from a study, while estrogen’s effects on the autoimmune disease community were still being tested.

So, where did these studies come from?

It turns out researchers have been studying for more than 30 years how mice are affected by estrogen. It is a fact that women are diagnosed more with lupus than men (15:1). Most patients are diagnosed between the ages of 15-45, when estrogen levels are at their highest. Correlation does not always imply causation, though, especially when it comes to the human body. I’ve spent weeks researching this topic and the most informative studies, up until about three years ago, involved mice, not humans.

But new studies with people are starting to show very different results …

… or no results at all. The National Institute of Medical Science and Nutrition in Mexico City did an experiment with female lupus patients and came to find that there was no difference between patients who were given estrogen, and patients who were given a placebo. While more studies need to be done for moderate-to-severe lupus patients, most of us can breathe a little easier knowing that estrogen does not cause flare-ups. According to the lead researcher on one of the studies (Dr. Michelle Petri, 2005), “Studies clearly show that most women with lupus can take oral contraceptives safely.”

The results are in folks

It turns out having lupus does not mean you cannot use birth control or HRT. As always, consult your doctor before adding or removing any medications or supplements from your diet. We also still have to be careful about the risks of birth control and HRT, just like anyone else. What we do not have to worry about, though, is it causing flare-ups. In fact, Petros Efthimiou, MD, suggests that estrogen may  help lupus patients by calming the peaks of estrogen that normally are found in women. He states in an article on NBC News, that “Now we’ll feel more comfortable with giving these women oral contraceptives.”


Note: Lupus News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Lupus News Today, or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to lupus.