More diffuse connective tissue diseases including SLE and antiphospholipid syndrome mainly involve women of childbearing age, and these patients are often unable to conceive due to the activity of the disease or are taking immunosuppressive drugs and need to take measures to prevent pregnancy. So, how can I use safe and effective contraception? This is very important for patients. The following is to introduce rheumatism patients contraceptive methods: 1, sex hormone contraceptives Sex hormone contraceptives are mainly divided into only progestin and estrogen and progestin containing compound preparations of two types, oral, external paste, intramuscular, subcutaneous and vaginal pessary and other preparations, including oral preparations for its convenience and reliability, does not affect sexual life, can improve menstrual disorders, prevent ovarian and endometrial cancer, reduce the risk of acute pelvic inflammatory disease, improve Short-acting estrogen and progestin combination oral formulations are recommended, especially for patients under 40 years of age with dysmenorrhea and heavy menstrual flow. Compared to the first and second generation oral combination formulations, the third generation oral combination formulation has a lower amount of estrogen (only 20-35 μg) and a higher selective effect of progestin. Low doses of estrogen significantly reduce adverse effects such as thrombosis, nausea, breast tenderness and vomiting, while the androgen-like effects (including weight gain, acne and elevated blood cholesterol) of newer progestins such as deprenyl, norepinephrine, pregnenolone and drospirenone (spironolactone analog) are significantly reduced, with drospirenone also having anti-androgen-like effects. However, these agents still carry a low risk of inducing thrombosis, so their absolute contraindications include: smokers older than 35 years; history of thrombotic, cerebrovascular, or coronary artery disease; difficult-to-control hypertension; diabetes mellitus with vascular complications; and a genetic predisposition to thrombosis. In addition, pregnancy, acute and chronic hepatitis and nephritis, and estrogen-dependent tumors (e.g., breast cancer) are absolute contraindications. Relative contraindications include hyperlipidemia, migraine and prolonged inactivity. Obesity (body mass index ≥ 25 kg/m2) is also a risk factor (10-fold increased risk) for thrombosis induced by administration, so use with caution in obese patients. In addition, to prevent postoperative venous thrombosis, users of these contraceptives should discontinue taking them 6 weeks before surgery, and heparin may be used prophylactically during surgery. Progestin-only oral contraceptives are mostly used in patients with contraindications to estrogen or as emergency contraceptives. These preparations do not induce thrombosis, but repeated long-term use can cause menstrual disturbances and androgen-like effects. There is a long-acting contraceptive pill (medroxyprogesterone, injected intramuscularly once every 3 months) with better efficacy than oral progestogenic contraceptives, which has the advantage of not reducing glucose tolerance and not causing hypertension and hypercholesterolemia, however, there are still adverse effects such as irregular vaginal bleeding, weight gain and reversible bone loss, and it takes a long time to resume fertility after interruption of the drug. 2, birth control ring birth control ring contraception to its effective, good compliance and no risk of thrombosis and popular with women in China, especially for normal menstruation and long-term contraception. Commonly used stainless steel round ring can contraception about 20 years, but the rate of shedding and with the ring pregnancy rate is high. The copper IUD is more effective and is valid for 10 years, with a lower rate of shedding and pregnancy with the IUD, but the incidence of heavy menstrual bleeding and dysmenorrhea is higher. At present, the newly released levonorgestrel intrauterine delayed release system mainly acts locally, avoiding the systemic adverse effects caused by progesterone, and has the greatest advantage of reducing menstrual blood flow by 75%, especially for those with heavy menstruation. However, irregular vaginal bleeding occurs during the first 3 months of use, and menopause occurs in 20% of cases after 1 year, with a short duration of use (5 years). Contraindications to IUD use include a history of ectopic pregnancy, pregnancy, pelvic inflammatory disease, unexplained vaginal bleeding, and uterine or cervical tumors. Relative contraindications include multiple sexual partners and severe immunodeficiency disease or long-term heavy use of immunosuppressive therapy. 3.Other contraceptive measures Other contraceptive measures include safety period contraception, tubal sterilization and external barrier contraception (condom and vaginal diaphragm), etc. Among them, safety period contraception and external barrier contraception have been considered the safest and preferred contraceptive methods for patients with rheumatic diseases. However, because menstruation and ovulation are often irregular in patients with rheumatic diseases due to a variety of factors, safe contraception is prone to failure. It is not suitable for people with severe arthritis as it is difficult to place the vaginal diaphragm into the vagina. Condoms are not contraindicated and are particularly suitable for people with multiple partners or STDs. Tubal sterilization as a permanent contraceptive is particularly suitable for those who no longer have children or cannot have children due to illness. In conclusion, there are more methods of contraception for rheumatism patients, rheumatologists and patients should clearly understand the disease itself and the advantages and disadvantages of each contraceptive method, and choose a safe and effective contraceptive method.