Systemic lupus erythematosus and hormone replacement therapy.
The indications for hormone replacement therapy (HRT) in postmenopausal women is the treatment of climacteric symptoms and the prevention of osteoporosis. Women with systemic lupus erythematosus (SLE) are more likely to have a premature menopause, osteoporosis and cardiovascular disease. HRT can induce SLE flares and cardiovascular or venous thromboembolic events. Therefore it should not be used in women with active disease or those with antiphospholipid (aPL) antibodies. In general, it should be used only for patients without active disease, a history of thrombosis or aPL antibodies. Non-oral administration of estrogen is recommended because of its lesser effect on coagulation. With regard to the progestogen, progesterone or pregnane derivatives are preferred. Otherwise, non-estrogen-based strategies should be used.
Gompel
A
A
Unité de gynécologie endocrinienne, Université Paris Descartes, APHP, Hôtel-Dieu, Paris, France. anne.gompel@htd.aphp.fr
Piette
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JC
D000818:Animals; D001943:Breast Neoplasms / Q000139:chemically induced; D000075202:Contraindications; D020847:Estrogen Receptor Modulators / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000378:metabolism; D008180:Lupus Erythematosus, Systemic / Q000276:immunology*; D009652:Norpregnenes / Q000627:therapeutic use; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control*; D011374:Progesterone / Q000627:therapeutic use; D011372:Progestins / Q000627:therapeutic use; D012107:Research Design; D018570:Risk Assessment; D013927:Thrombosis / Q000139:chemically induced; D016387:Women's Health
D020847:Estrogen Receptor Modulators; D016682:Lupus Coagulation Inhibitor; D009652:Norpregnenes; D011372:Progestins; D011374:Progesterone; C027385:tibolone