Comprehensive reproductive healthcare for women with immune-mediated inflammatory diseases: Addressing rheumatoid arthritis, spondyloarthritis and inflammatory bowel disease through life's stages

Autoimmun Rev. 2024 Mar;23(3):103507. doi: 10.1016/j.autrev.2023.103507. Epub 2023 Dec 22.

Abstract

Immuno-mediated inflammatory diseases (IMIDs) such as rheumatoid arthritis, spondyloarthritis, and inflammatory bowel disease are characterised by pathophysiological mechanisms wherein the immune system erroneously targets the body's own tissues. This review explores the heightened vulnerability of women with IMIDs, influenced by hormonal modulators like estrogen and progesterone. The challenges this poses are multifaceted, encompassing the impact of active disease and medical treatments throughout life stages, including family planning, fertility, and menopause. From the perspectives of rheumatologists and gastroenterologists, we review current management strategies and underscore the need for a multidisciplinary and life-cycle approach to healthcare for women with IMIDs.

Keywords: Contraception; Fertility; Immune-mediated inflammatory diseases (IMIDs); Inflammatory bowel disease (IBD); Menopause; Rheumatoid arthritis (RA); Sexual health; Spondyloarthritis (SpA).

Publication types

  • Review

MeSH terms

  • Arthritis, Rheumatoid* / drug therapy
  • Arthritis, Rheumatoid* / immunology
  • Arthritis, Rheumatoid* / therapy
  • Female
  • Humans
  • Inflammatory Bowel Diseases* / immunology
  • Inflammatory Bowel Diseases* / therapy
  • Reproductive Health
  • Spondylarthritis* / drug therapy
  • Spondylarthritis* / immunology
  • Spondylarthritis* / therapy