Oral contraceptives and rheumatoid arthritis: results from a primary care-based incident case-control study

Semin Arthritis Rheum. 1997 Jun;26(6):817-23. doi: 10.1016/s0049-0172(97)80025-x.


Objective: The possibility that oral contraceptives offer a protective effect against the development of rheumatoid arthritis is still contentious. Of the 17 studies investigating this association, 11 have found a protective effect, and 6 have not. These differences are probably attributable to either selection or information biases in a subset of studies, although the exact reason is unknown. To overcome the methodological problems inherent in the design of previous studies, we have conducted a population-based case-control study.

Methods: Women who were incident cases of inflammatory polyarthritis, defined as swelling of at least two joint areas lasting at least 4 weeks, were recruited directly from primary care and compared with age-matched women from the same population.

Results: Cases and controls reported a similar level of "ever use" of oral contraceptives, adjusted odds ratio = 0.88 (95% confidence interval, 0.47, 1.64). The cases were, however, less likely to report using oral contraceptives at the time of onset, adjusted odds ratio = 0.22 (95% confidence interval, 0.06, 0.85). Similar results were observed for cases who satisfied the criteria for rheumatoid arthritis and cases who did not.

Conclusion: These results indicate that only current oral contraceptive use protects against the development of inflammatory polyarthritis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / epidemiology
  • Arthritis, Rheumatoid / prevention & control*
  • Case-Control Studies
  • Contraceptives, Oral / therapeutic use*
  • Female
  • Humans
  • Middle Aged
  • Primary Health Care
  • Surveys and Questionnaires
  • United Kingdom / epidemiology


  • Contraceptives, Oral