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This study was conducted to find out the association between estrogen exposure and systemic lupus erythematosus (SLE) in Bangladeshi women.

A case-control study was carried out from January to December 2015 among 128 intervention cases and 128 age-matched control group participants to find out the association with estrogen exposure and development of SLE.

Case group participants were five times (OR 5.14, 95% CI 2.14–12.33), three times (OR 3.40, 95% CI 1.25–9.21) and four times (OR 4.00, 95% CI 1.45–11.00) more likely to receive different higher levels of education compared to the control group. Exposure to estrogen showed a positive association with the development of SLE. The case group (12.63 ± 1.61 years) had a lower age at menarche than that of the control group (13.31 ± 1.47 years; p < 0.001) and their proportion (62.6%) of using oral contraceptive pills were more than that of the control group (45.6%; p < 0.01). After controlling the effect of the positively associated variables, SLE patients were found two times (adjusted OR 2.26; 95% CI 1.29–3.95) more likely to use oral contraceptive pills than the control group. The case group was more (adjusted OR 0.771; 95% CI 0.642–0.927) prone to have an earlier age at menarche compared to the control group.

This study identified the association between estrogen exposure and SLE. Contraceptive pills should be used cautiously and both consumers and service providers need to be aware of their effects.