A sexually active young woman with systemic lupus erythematosus (SLE) complicated by lupus nephritis was hospitalized for a lupus flare after discontinuing treatment with her medications. The patient had been diagnosed in her teens and received induction therapy with cyclophosphamide followed by maintenance therapy with mycophenolate mofetil. Despite being sexually active, she reported no contraceptive counseling at the time of diagnosis or prior to initiation of treatment with potentially teratogenic medications.