There are several types of lupus, but people often use the word “lupus” to mean systemic lupus erythematosus (SLE), the most common form of the disease. All types of lupus are autoimmune conditions that cause your body’s immune system to attack organs and tissues.
Despite the fact that lupus overwhelmingly affects women in their reproductive years, sexual and reproductive health is still one of the least studied areas in lupus research. Because lupus can attack so many body systems, your symptoms can range from fatigue to skin rashes, hair loss, and kidney disease. These symptoms, and their treatments, can have a significant impact on sexual and reproductive health.
Understanding how lupus can affect your sexual health and fertility is important for making treatment decisions and maintaining your quality of life. Here are some of the common ways lupus can affect your sexual and reproductive health.
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Lupus can cause you to start puberty later
For people diagnosed with lupus in childhood, puberty may start later than average, although researchers aren’t sure exactly why. Some theories include:
- Nutritional deficiencies caused by the disease
- Long-term steroid treatment
- The inflammatory process of lupus itself
Lupus can also take an extra toll on the body and if symptoms are more severe, this can cause children to start puberty later than their peers.
Lupus can cause menstrual problems
Lupus can cause menstrual problems such as: heavy bleedingyou do not have a period or have irregular cycles.
This may be because lupus can attack your ovaries, which regulate your hormone levels. Lupus outbreakswhen new symptoms appear or suddenly become worse or more bothersome, it may be due to increased estrogen levels — which occur right before menopause.
Another cause of irregular periods with lupus can be steroid treatments or immunosuppressive drugs that treat the disease. These drugs can make the ovaries not work as they should.
Lupus may increase the risk for vaginal infection
Vaginal infections such as yeast infections and bacterial vaginosis (BV) may be more common when living with lupus. This is because the disease itself and the drugs you take to treat it can suppress the immune system. And infections occur more often when your body can’t effectively fight infection.
For yeast infections, an over-the-counter (OTC) antifungal treatment can sometimes take care of the infection, but other times prescription treatments are needed. BV must be treated with a prescription antibiotic, so be sure to check with your healthcare provider.
Lupus may increase the risk of cervical cancer
A virus known as the herpes papillomavirus (HPV) can cause cervical cancer. HPV lesions and early cancerous lesions have been found to be higher among women with lupus. This may be related to the lupus itself or the immunosuppressive drug used to treat the lupus. Regular Pap smears with your gynecologist are important for prevention.
Lupus can cause vaginal dryness
Lupus can affect the way your ovaries work control estrogen levels. Lower estrogen levels can cause symptoms such as vaginal dryness, irritation and pain during sex.
If you experience vaginal dryness, lubricants are an option to help make sexual activity more comfortable. Be sure to choose a lubricant that does not contain glycerin and has the correct PH (between 4.8 and 4.5) so that it does not cause a yeast infection.
Adding estrogen as a treatment option can help increase estrogen levels, which may improve symptoms. But it may not be safe in all forms of lupus. Some studies show that hormone therapy containing estrogen can cause lupus flares, worsen the disease, or increase the risk of blood clots. It is important to discuss the risks versus benefits of estrogen and the safest route to take estrogen (topical, vaginal, oral) if they are considered safe with your rheumatologist.
Lupus can cause fertility problems
Fertility concerns can arise because of lupus itself or because of its treatments.
About 3 in 10 women with lupus have antiphospholipid antibodies (aPL). These antibodies can put you at risk for blood clots, and this can make it harder to get pregnant. Lupus can also cause irregular periods, which can make it difficult to determine the best time to try for pregnancy.
Cyclophosphamide, a lupus drug used for more severe forms of lupus, can also affect your fertility because it stops your ovaries from releasing eggs each month.
You may decide to freeze your eggs for later use when your lupus is under control and you are taking medications that are safe to take during pregnancy. Other treatments such as in vitro fertilization (IVF) can help achieve pregnancy if you are having trouble conceiving.
Lupus can cause complications in pregnancy
You can still get pregnant and have a healthy pregnancy when you live with lupus, but lupus increases the risk of pregnancy complications. Good planning can reduce these risks, so it’s important to let your rheumatologist and gynecologist know about your pregnancy plans so you can work together to reduce your risk.
This risk Lupus pregnancy complications it is higher if you have:
These conditions put you at higher risk for preeclampsia, miscarriage, or premature birth.
Pregnancy is also a time when you may have lupus flare-ups due to fluctuating hormone levels. Therefore, it is important to have regular follow-ups with your rheumatologist along with your OB-GYN during pregnancy.
Feel free to ask questions about the wolf
Fertility, sexual health and pregnancy are common concerns for people living with lupus.
But different symptoms affect each person in a unique way.
It can sometimes be difficult to know if your symptoms are affecting your sexual and reproductive health and if you can do something about it. Don’t be afraid to bring up your concerns and questions with your care team so you can get some answers.
This educational resource was created with the support ofm Merck.
