Hormone replacement and contraceptive therapy in autoimmune diseases

► The sex hormones play a significant role in the pathophysiology of autoimmune rheumatic diseases. ► Hormonal therapies (OCs and HRT) are effective in the majority of patients with rheumatic diseases. ► However, their use should be avoided in women with severe active SLE and hypercoaguable states. ► HRT led to an increase in mild to moderate SLE flares in the HRT-SELENA trial. ► OCs may improve RA disease activity and are an effective and safe option for young women with RA.