Detrimental effect of oral contraceptives on parameters of bone mass and geometry in a cohort of 248 young women

Hartard, Manfred; Kleinmond, Christine; Wiseman, Michael; Weissenbacher, E. R.; Felsenberg, Dieter; Erben, Reinhold G.

doi:10.1016/j.bone.2006.08.001

Cited by 67 publications

(46 citation statements)

References 35 publications

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“…Depot medroxyprogesterone acetate is the most commonly used injectable method and acts by inhibiting the release of both lutenising and follicle-stimulating hormones resulting in the suppression of ovarian synthesis of estradiol and progesterone, both important osteogenic hormones. The literature is not clear regarding the effect of oral contraceptive use, the predominant contraceptive used by white women, on BMD [40] [41]. In our regression model, oral contraceptive use was independently associated with lower LS BMD in white women.…”

Section: Discussionmentioning

confidence: 71%

Site-specific differences in bone mineral density in black and white premenopausal South African women

et al. 2011

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Section: Discussionmentioning

confidence: 71%

Site-specific differences in bone mineral density in black and white premenopausal South African women

et al. 2011

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“…Her diagnosis is unknown, and she received oral contraceptives since. There is evidence that women treated with oral contraceptives from a young age have an increased risk for low bone mineral density [10].…”

Section: Discussionmentioning

confidence: 99%

Severe postpartum osteoporosis with increased PTHrP during lactation in a patient after total thyroidectomy and parathyroidectomy

et al. 2011

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We present a 27-year-old woman with hypoparathyroidism following total thyroidectomy for papillary carcinoma, who presented postpartum during lactation with several vertebral osteoporotic fractures, increase in bone turnover markers, and measurable parathyroid hormone-related protein (PTHrP) levels. Cessations of lactation led to gradual decrease in bone turnover markers and PTHrP and improvement in bone mineral density. Pregnancy- and postpartum-associated osteoporosis is an uncommon condition characterized by the occurrence of fractures during late pregnancy or the puerperium. The patient presented postpartum with severe back pain and multiple vertebral fractures. Metabolic evaluation performed at presentation revealed hypercalcemia, hypercalciuria, increased alkaline phosphatase, vitamin D insufficiency, normal serum protein immunoelectrophoresis, and a detectable level of PTHrP. Serum levels of bone turnover markers were markedly increased. Bone mineral density at the lumbar spine was severely reduced. After cessation of lactation, the PTHrP level became undetectable. Bone turnover markers gradually decreased to normal and bone mineral density improved. Several factors contributed to the reduced bone mass in this patient, including amenorrhea treated with oral contraceptives, suppressive levothyroxine treatment, and lactation of twins with increased PTHrP. Patients with severely reduced bone mass need surveillance during pregnancy and lactation and should possibly consider avoiding breastfeeding. Patients with hypoparathyroidism should temporarily reduce their alphacalcidiol dose while lactating.

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“…More recently, Hartard et al published a cross sectional analysis assessing the impact of COC use in women aged 18-24. Compared to never users of COCs, women who reported ever using COCs had a 5% lower BMD at the femoral neck (p<0.005) despite similar age, height, weight, BMI, hours of exercise per week and calcium intake [62]. In a study published by Cromer et al in 2008, adolescents aged 12-18 were followed for 24-months.…”

Section: Combination Oral (Coc): Skeletal Impact In Adolescentsmentioning

confidence: 91%

“…To date, the body of evidence suggests that adolescents currently using COCs have lower BMD than non-users [34,[58][59][60][61][62][63][64]. In a systematic review published in 2006, Martins et al identified four "poor" to "good" quality articles that examined the relationship between COC use and BMD in adolescents [7].…”

Section: Combination Oral (Coc): Skeletal Impact In Adolescentsmentioning

confidence: 96%

Update on hormonal contraception and bone density

Isley

Kaunitz

2011

Rev Endocr Metab Disord

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Combination hormonal contraception and progestin-only contraception (including depot medroxyprogesterone acetate [DMPA]) are effective and convenient forms of reversible contraception that millions of women use worldwide. In recent years, observations of reduced bone mineral density in current users of these methods have led to concerns that this hormone-induced bone loss might translate into long-term increased fracture risk. Special focus has been placed on adolescent users who have not yet attained their peak bone mass as well as perimenopausal users. In 2004, the FDA added a black box warning to DMPA package labeling warning of the risk of significant bone loss and cautioning against long-term use (> 2 years). This article reviews evidence on the use of hormonal contraception and its effect on bone density in adolescent, premenopausal, and perimenopausal populations. Recommendations from reproductive healthcare organizations are reviewed and clinical recommendations are provided.

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Detrimental effect of oral contraceptives on parameters of bone mass and geometry in a cohort of 248 young women

Cited by 67 publications

References 35 publications

Site-specific differences in bone mineral density in black and white premenopausal South African women

Site-specific differences in bone mineral density in black and white premenopausal South African women

Severe postpartum osteoporosis with increased PTHrP during lactation in a patient after total thyroidectomy and parathyroidectomy

Update on hormonal contraception and bone density

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