Combined hormonal contraception and bone health: a systematic review

This systematic review examined whether women who use combined hormonal contraception experience changes in risk of fracture or bone mineral density (BMD) that differ from nonusers. We identified 86 articles from PubMed and EMBASE (published 1966 to August 2005) that reported on fracture or BMD outc...

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Bibliographic Details
Published inContraception (Stoneham) Vol. 73; no. 5; pp. 445 - 469
Main Authors Martins, Summer L., Curtis, Kathryn M., Glasier, Anna F.
Format Journal Article
LanguageEnglish
Published New York, NY Elsevier Inc 01.05.2006
Elsevier Science
Subjects
Age Factors
Biological and medical sciences
Birth control
Bone Density - drug effects
Bone mineral density
Contraceptives, Oral, Combined - pharmacology
Female
Fracture
Fractures, Bone - etiology
Genital system. Reproduction
Gynecology. Andrology. Obstetrics
Hormonal contraception
Humans
Medical sciences
Menopause
Pharmacology. Drug treatments
Systematic reviews
Systematic reviews
Fracture
Bone mineral density
Hormonal contraception
Human
Toxicity
Diseases of the osteoarticular system
Estrogen
Oral administration
Systematic review
Contraception
Review
Trauma
Progestagen
Risk factor
Female
Bone
Age
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Summary:This systematic review examined whether women who use combined hormonal contraception experience changes in risk of fracture or bone mineral density (BMD) that differ from nonusers. We identified 86 articles from PubMed and EMBASE (published 1966 to August 2005) that reported on fracture or BMD outcomes by use of combined hormonal contraceptives. The evidence relating to combined oral contraceptives (COCs) and fracture is inconclusive, as results from the available studies conflict. Studies of adolescent and young adult women generally found lower BMD among COC users than nonusers. Evidence for premenopausal adult women suggested no differences in BMD between COC users and nonusers. COC use in perimenopausal and postmenopausal women preserved bone mass, while nonusers lost BMD, but BMD among former COC users in this age group was the same as for never-users. Evidence for other combined hormonal methods was very limited, with one study indicating no effect of combined hormonal injectable use among premenopausal women on BMD and one study suggesting lower BMD among premenopausal users of the NuvaRing than in nonusers.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Review-3
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ISSN:0010-7824
1879-0518
DOI:10.1016/j.contraception.2006.01.003