Menstrual Characteristics in Black Women with Systemic Lupus Erythematosus (SLE) in Atlanta, Georgia Public

Berry, Jasmine (Spring 2022)

Permanent URL: https://etd.library.emory.edu/concern/etds/j38608266?locale=fr
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Abstract

Objective Black women with SLE experience a more sever disease progression, more organ damage, earlier onset of disease, and higher disease activity than White women with SLE, which may make them more susceptible to developing secondary amenorrhea and experiencing fertility issues. This study evaluated the association between secondary amenorrhea and SLE among Black women.

Methods Women, ages 22-40, who lived in Metro Atlanta, were diagnosed with SLE at ages 18-35, did not have a hysterectomy, did not have a history of cancer, and were not receiving dialysis were eligible for the study. Women in Metro Atlanta were recruited via a marketing list for the comparison group. All women were interviewed about their medical and reproductive histories. Secondary amenorrhea was defined as an absent menstrual period for 3 months or more. Multivariate logistic regression was used to examine the association between SLE status and secondary amenorrhea and between type of SLE medication and secondary amenorrhea. Models were adjusted for age at interview, smoking status, and body mass index. Secondary analyses stratified on contraceptive use and on reproductive conditions.

Results The study population included 89 women with SLE and 163 women without SLE. Women with SLE had a higher odds of secondary amenorrhea compared to women without SLE (aOR: 3.0, 95% CI: 1.3-6.8). Mycophenolate mofetil was associated with secondary amenorrhea (cOR: 2.0, 95% CI: 0.7-5.6) but not azathioprine (cOR: 1.0, 95% CI: 0.4-2.7) among women with SLE. However, these associations were imprecise.

Conclusions Secondary amenorrhea is more prevalent among women with SLE compared to women without SLE. Some medications, but not others, may contribute to the occurrence of secondary amenorrhea.  

Table of Contents

Chapter 1: Literature Review. 1

Systemic Lupus Erythematosus (SLE) Background. 1

Epidemiology Of SLE. 3

Epidemiology Of Menstruation And Amenorrhea. 3

Reproductive Issues And SLE. 5

Effect Of SLE Medications On Reproductive Health. 7

Present Study. 11

References. 12

Chapter 2: Secondary Amenorrhea In Black Women Diagnosed With Systemic Lupus Erythematosus In Atlanta, Georgia. 20

Methods. 21

Results. 24

Discussion. 28

References. 31

Tables. 36

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