Systemic lupus erythematosus (SLE) can affect the menstruation, fertility, and 
pregnancy outcomes of the affected subjects. There is very little data on this 
aspect of the disease in Indian patients. Our aim was to study the menstrual, 
fertility, and pregnancy outcomes in these patients in comparison with patients 
of rheumatoid arthritis (RA) and also to study the effect of cyclophosphamide 
therapy on menstrual cycles in patients with SLE. Four hundred and twenty 
patients of SLE (210) and RA (210) were interviewed using a standard 
questionnaire and available medical records used. After disease-onset, the 
chances of adverse pregnancy outcomes were significantly more in patients with 
SLE compared to RA [OR = 5.17 (2.13-12.52); p ≤ 0.001]. Compared to the National 
average in India, the average number of living children is lesser in patients 
with RA (2.39 ± 1.39, p = 0.002), but more so in patients with SLE (1.44 ± 1.35, 
p = 0.001). A younger age at diagnosis and cyclophosphamide therapy was found to 
be independently associated with menstrual irregularities after disease-onset. 
We conclude that pregnancy outcome in patients with SLE in India is worse in 
comparison to patients with RA. Average family size of patients with SLE and RA 
is less when compared to National average in India. Patients with SLE are more 
prone for menstrual irregularities, especially those who receive 
cyclophosphamide treatment.