Abstract
Background
The associations between oral contraceptive (OC) use, bone mineral density (BMD) and
the risk of fractures remain controversial.
Study Design
A cross-sectional study of 491 women aged 50���80 years was performed. We assessed
OC use and fractures by questionnaire, and BMD and vertebral deformity by dual-energy
x-ray absorptiometry.
Results
Ever use of OC was associated with significantly higher BMD at the total body (6%,
p<.001) and spine (4%; p=.05) (but not hip) after adjustment for confounders. There
was also a significant association between duration of OC use and total body and spine
BMD. Use of OCs for 5���10 years was associated with reduced vertebral deformity (adjusted
odds ratio 0.46, 95% confidence interval 0.22���0.94).
Conclusions
Oral contraceptive use and duration were associated with higher total body and spine
BMD and a consistent reduction in vertebral deformities, although most associations
did not reach significance.
Keywords
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References
- Osteoporotic fractures: mortality and quality of life.Panminerva Med. 2007; 49: 21-27
- Sex steroids and the construction and conservation of the adult skeleton.Endocr Rev. 2002; 23: 279-302
- Estrogens maintain bone mass by regulating expression of genes controlling function and life span in mature osteoclasts.Ann N Y Acad Sci. 2009; 1173: E31-E39
- Oral hormone therapy with 17beta-estradiol and 17beta-estradiol in combination with norethindrone acetate in the prevention of bone loss in early postmenopausal women: dose-dependent effects.Menopause. 2005; 12: 741-748
- A 10-year follow-up of the effect of continuous-combined hormone replacement therapy and its discontinuation on bone in postmenopausal women.Menopause Int. 2008; 14: 70-77
- HRT and vit D in prevention of non-vertebral fractures in postmenopausal women; a 5 year randomized trial.Maturitas. 2008; 61: 85-94
- Oral contraceptives and bone mineral density: a population-based study.Am J Obstet Gynecol. 2000; 182: 265-269
- Bone mineral density in adolescent and young adult women on injectable or oral contraception.Curr Opin Obstet Gynecol. 2003; 15: 353-357
- Oral contraceptive use and bone mass in women aged 26���36 years.Osteoporos Int. 2011; 22: 351-355
- Effects of hormonal contraception on bone mineral density after 24 months of use.Obstet Gynecol. 2004; 103: 899-906
- Oral contraceptive use and bone.Curr Osteoporos Rep. 2011; 9: 6-11
- Longitudinal evaluation of perimenopausal bone loss: effects of different low dose oral contraceptive preparations on bone mineral density.Maturitas. 2006; 54: 176-180
- Longitudinal changes in bone density in relation to oral contraceptive use.Contraception. 2003; 68: 177-182
- Effects of an oral contraceptive containing drospirenone on bone turnover and bone mineral density.Obstet Gynecol. 2005; 105: 53-60
- Steroidal contraceptives: effect on bone fractures in women.Cochrane Database Syst Rev. 2009; : CD006033
- Severity of prevalent vertebral fractures and the risk of subsequent vertebral and nonvertebral fractures: results from the MORE trial.Bone. 2003; 33: 522-532
- Colles fracture, spine fracture, and subsequent risk of hip fracture in men and women. A meta-analysis.J Bone Joint Surg Am. 2003; 85-A: 1936-1943
- Prevalent vertebral deformities predict hip fractures and new vertebral deformities but not wrist fractures. Study of Osteoporotic Fractures Research Group.J Bone Miner Res. 1999; 14: 821-828
- Asymptomatic vertebral deformity as a major risk factor for subsequent fractures and mortality: a long-term prospective study.J Bone Miner Res. 2005; 20: 1349-1355
- Oral contraceptive use and risk of fractures.Contraception. 2006; 73: 571-576
- Influence of hormonal and reproductive factors on the risk of vertebral deformity in European women. European Vertebral Osteoporosis Study Group.Osteoporos Int. 1997; 7: 72-78
- Determinants of incident vertebral fracture in men and women: results from the European Prospective Osteoporosis Study (EPOS).Osteoporos Int. 2003; 14: 19-26
- Development of the Melbourne FFQ: a food frequency questionnaire for use in an Australian prospective study involving an ethnically diverse cohort.Asia Pac J Clin Nutr. 1994; 3: 19-31
- MIMS annual.33rd ed. CMPMedica, St Leonards NSW2009
- Oral contraceptives and bone mineral density in white and black women in CARDIA. Coronary Risk Development in Young Adults.Osteoporos Int. 2002; 13: 893-900
- Lifestyle factors and the development of bone mass and bone strength in young women.J Pediatr. 2004; 144: 776-782
- Oral contraceptive use in young women is associated with lower bone mineral density than that of controls.Osteoporos Int. 2005; 16: 1538-1544
- The influence of lifestyle, menstrual function and oral contraceptive use on bone mass and size in female military cadets.Nutr Metab (Lond). 2007; 4: 17
- Detrimental effect of oral contraceptives on parameters of bone mass and geometry in a cohort of 248 young women.Bone. 2007; 40: 444-450
- Oral contraceptive use may protect against low bone mass. Henry Ford Hospital Osteoporosis Cooperative Research Group.Arch Intern Med. 1991; 151: 1971-1976
- Effects of menstrual history and use of medications on bone mineral density: the EVOS Study.Calcif Tissue Int. 1998; 63: 271-276
- Bone mineral density in postmenopausal women as determined by prior oral contraceptive use.Am J Public Health. 1993; 83: 100-102
- Risk of low bone density in women attending menopause clinics in Italy.Maturitas. 2002; 42: 105-111
- Effect of combined oral contraceptives on bone mineral density in pre and postmenopausal women.Mymensingh Med J. 2002; 11: 12-14
- Risk factors for osteoporosis in postmenopausal African���American women.Curr Med Res Opin. 2004; 20: 1681-1687
- Effects of estrogen plus progestin on risk of fracture and bone mineral density: the Women's Health Initiative randomized trial.JAMA. 2003; 290: 1729-1738
- Lack of relationship between hip and spine bone mineral density and oral contraceptive use.Eur J Clin Invest. 1993; 23: 108-111
- Influence of breastfeeding and other reproductive factors on bone mass later in life.Osteoporos Int. 1993; 3: 76-83
- Related factors in bone mineral density of lumbal and femur in natural postmenopausal women.Arch Gynecol Obstet. 2005; 273: 86-89
- Reproductive, menstrual and menopausal factors: which are associated with bone mineral density in early postmenopausal women?.Osteoporos Int. 2001; 12: 777-787
- The effect of past use of oral contraceptive on bone mineral density, bone biochemical markers and muscle strength in healthy pre and post menopausal women.BMC Womens Health. 2009; 9: 31
- Effects of hormonal status on bone density in adolescent girls.J Clin Endocrinol Metab. 1990; 71: 1083-1088
- Determinants of peak trabecular bone density in women: the role of androgens, estrogen, and exercise.J Bone Miner Res. 1988; 3: 673-680
- Effect of oral contraceptives and hormone replacement therapy on bone mineral density in premenopausal and perimenopausal women: a systematic review.Br J Sports Med. 2006; 40: 11-24
- Oral-contraceptive use and risk of hip fracture: a case���control study.Lancet. 1999; 353: 1481-1484
Article info
Publication history
Published online: March 16, 2011
Accepted:
February 2,
2011
Received in revised form:
February 1,
2011
Received:
December 24,
2010
Identification
Copyright
© 2011 Published by Elsevier Inc. All rights reserved.