Lupus and Reproductive Health: Why Your OB-GYN Is Your Best Friend

Ever since I was diagnosed with lupus, I have had revolving appointments and have seen so many doctors. But, the one appointment that I’ve always had prior to my diagnosis was my annual OB-GYN appointment. I dreaded this appointment, but I knew I needed it.  Now, that I have lupus, this annual checkup is even more important. Lupus is a complex autoimmune disease that affects many organs that predominantly affecting women, and diagnosis is usually in their childbearing years. As a result, lupus has many effects on reproductive health and needs to be monitored carefully. Early detection is key!

The Importance of Annual OB-GYN Checkups

The primary goal of an annual OB-GYN appointment is to provide a thorough assessment of a woman's reproductive health. This includes a blood test, urinalysis, a pelvic exam, breast exam, and pap smears to screen for cervical cancer. These tests might make you feel scared, nervous, and uncomfortable, especially if it’s your first time. If you have any questions about the process, please ask your doctor and inform them about any issues you might have with these tests. The exams are usually painless and take less than 10 minutes. There might be some discomfort after the pap smear, but it will go away.

The tests will be able to determine if you have any STDs/STIs, kidney issues, precancerous or cancerous cells in your cervix, lumps in your breast or infections. If you are able to detect issues early, proper treatment can be planned as soon as possible. Besides, the tests performed, you can also discuss any problems with sex or birth control, pelvic pain, menstrual changes or abnormal bleeding.

Family Planning and Lupus

For women with lupus who wish to start a family, OB-GYNs play a vital role in family planning. Many lupus patients wonder if they can have a successful pregnancy and the answer is yes with the proper plan. Lupus patients will need to be heavily monitored and need to ensure that their lupus is under control. OB-GYNs will be able to help discuss the best time for conception, fertility preservation options, and the management of lupus during pregnancy.

Medication and Pregnancy with Lupus

Many lupus patients also take many medications to control our symptoms that suppresses our immune systems. Some of these medications like Cytoxan or Cellcept can affect fertility or increase the risk of birth defects and should not be taken if women are planning to get pregnant or are pregnant. Proper medication management is vital. If they are not ready yet for pregnancy, discussions about the proper birth control and the steps needed to get there needs to be discussed. Being monitored by an OB-GYN and your rheumatologist can help mitigate these risks by offering personalized care and timely interventions to get patients to that next step.

The Role of a High-Risk OB-GYN

Once lupus patients are pregnant, they will need to see their regular OB-GYN as well as a maternal fetal medicine specialist (high risk OB-GYN). Lupus pregnancies are considered high risk because of all of the added complications. The maternal fetal medicine specialist has more years in training than a regular OB-GYN and are equipped to handle high risk pregnancies. Since we are considered high risk, we are prone to premature births, preeclampsia and miscarriages.

Collaboration for a Healthier You

Each women with lupus is unique. So, it’s not a one size fits all treatment plan. We need the individualized care that can help our needs. So, along with your rheumatologist, an OB-GYN plays a vital role in our everyday health whether its just an annual screening, on the road to pregnancy or when you are pregnant. The collaboration between your medical team ensures that your lupus and reproductive health is being appropriately monitored.