There are different types of lupus, but the word “lupus” is often used to refer to systemic lupus erythematosus (SLE), the most common form of the disease. All types of lupus are autoimmune diseases that cause your body’s immune system to attack organs and tissues.
Although lupus predominantly affects women of childbearing age, sexual and reproductive health is still one of the most understudied areas in lupus research. Because lupus can attack so many body systems, your symptoms can be varied, from fatigue to skin rashes to hair loss and kidney disease. These symptoms and their treatment can have a significant impact on sexual and reproductive health.
To make treatment decisions and maintain your quality of life, it is important to understand how lupus can affect your sexual health and fertility. Here are some of the most common effects of lupus on your sexual and reproductive health.
Read: Lupus FAQs >>
Lupus can cause puberty to start later
People diagnosed with lupus in childhood may begin puberty later than average, although researchers don’t know exactly why. Some theories include:
- Nutrient deficiencies caused by the disease
- Long-term steroid treatment
- The inflammatory process of lupus itself
Lupus can put additional strain on the body and, if symptoms are more severe, can cause children to reach puberty later than their peers.
Lupus can cause menstrual problems
Lupus can cause menstrual problems such as heavy bleeding, missed periods, or irregular cycles.
This may be because lupus can attack the ovaries, which regulate your hormone levels. Lupus flare-ups, in which new symptoms appear or suddenly worsen or become more bothersome, may occur due to increased estrogen levels that occur immediately before the period.
Another cause of irregular periods in lupus could be steroid treatments or immunosuppressive medications used to treat the disease. These medications can cause the ovaries to stop functioning as they should.
Lupus can increase the risk of a vaginal infection
Vaginal infections such as yeast infections and bacterial vaginosis (BV) may occur more frequently if you live with lupus. This is because both the disease itself and the medications you take to treat it can weaken the immune system. And infections occur more often when your body can’t fight infections effectively.
For yeast infections, sometimes an over-the-counter yeast treatment can cure the infection, but sometimes prescription treatments are necessary. BV must be treated with a prescription antibiotic. Therefore, be sure to consult your doctor.
Lupus can increase your risk of cervical cancer
A virus known as herpes papillomavirus (HPV) can cause cervical cancer. HPV and early cancer lesions have been found to be higher in women with lupus. This may be related to lupus itself or the immunosuppressants used to treat lupus. Regular, routine Pap tests with your gynecologist are important for prevention.
Lupus can cause vaginal dryness
Lupus can affect how your ovaries control estrogen levels. Low estrogen levels can cause symptoms such as vaginal dryness, irritation, and pain during sex.
If you suffer from vaginal dryness, lubricants are one way to make sexual activity more comfortable. Be sure to choose a lubricant that is glycerin-free and has the right 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, potentially improving symptoms. However, it may not be safe for all forms of lupus. Some studies show that estrogen-containing hormone therapy may trigger lupus flares, worsen the disease, or increase the risk of blood clots. It is important to discuss with your rheumatologist the risks versus benefits of estrogen and the safest way to take estrogen (topical, vaginal, oral) if deemed safe.
Lupus can cause fertility problems
Fertility problems can occur due to lupus itself or its treatments.
About three in ten women with lupus have antiphospholipid antibodies (aPL). These antibodies can increase the risk of blood clots, which can make it more difficult to get and stay pregnant. Lupus can also cause irregular periods, which can make it difficult to determine the best time to try to get pregnant.
Cyclophosphamide, a lupus drug used for more severe forms of lupus, may also affect your fertility because it stops your ovaries from releasing eggs each month.
You can freeze your eggs for later use if 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 you get pregnant if you are having difficulty getting pregnant.
Lupus can cause pregnancy complications
You can still get pregnant and have a healthy pregnancy if you live with lupus, but having lupus increases your risk of pregnancy complications. Good planning can reduce these risks. Therefore, it is important to tell your rheumatologist and gynecologist about your plans for pregnancy so that you can work together to reduce your risk.
The risk of pregnancy complications from lupus is higher if you:
These conditions increase the risk of preeclampsia, miscarriage, or premature birth.
Lupus flare-ups can also occur during pregnancy due to fluctuating hormone levels. It is therefore important that you have regular check-ups with your rheumatologist and your gynecologist during pregnancy.
Don’t be afraid to ask questions about lupus
Fertility, sexual health, and pregnancy are common concerns for people with lupus.
But different symptoms affect each person in unique ways.
Sometimes it can be difficult to figure out whether your symptoms are affecting your sexual and reproductive health and whether there is anything you can do about it. Don’t be afraid to bring up your concerns and questions with your care team so you can get answers.
This educational resource was created with support from Merck.
