Steroidal contraceptives and bone fractures in women: evidence from observational studies

Lopez, Laureen M; Chen, Mario; Mullins, Sarah; Curtis, Kathryn M.; Helmerhorst, Frans M.

doi:10.1002/14651858.cd009849.pub2

Cited by 12 publications

(4 citation statements)

References 50 publications

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“…A Cochrane Review of observational studies172 reported that the evidence identified does not indicate an overall association between oral contraceptive use and fracture risk.…”

Section: Non-contraceptive Health Benefits Associated With Chc Usementioning

confidence: 99%

FSRH Guideline (January 2019, amended October 2023) Combined Hormonal Contraception

2019

BMJ Sex Reprod Health

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“…A Cochrane Review of observational studies172 reported that the evidence identified does not indicate an overall association between oral contraceptive use and fracture risk.…”

Section: Non-contraceptive Health Benefits Associated With Chc Usementioning

confidence: 99%

FSRH Guideline (January 2019, amended October 2023) Combined Hormonal Contraception

2019

BMJ Sex Reprod Health

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“…Aromatični inhibitori su važan dodatak endokrinoj terapiju za lečenje estrogen -receptor pozitivnog raka dojki [4,5,25]. Oni su inhibitori citohrom P450 CYP-19 enzima, koji konvertuju androgene u estrogene.…”

Section: Aromatični Inhibitoriunclassified

Osteoporoza prouzrokovana lekovima

Nestorović¹,

Rašić

Hudomal

et al. 2013

Biomedicinska istraž.

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2 Institut za farmakologiju i toksikologiju, Medicinski fakultet Priština sa sedištem u Kosovskoj Mitrovici, Srbija 3 Institut za patofiziologiju, Medicinski fakultet Priština sa sedištem u Kosovskoj Mitrovici, Srbija Kratak sadržajSve je veći broj istraživanja koja otkrivaju da mnogi lekovi ispoljavaju neže-ljene efekte na mineralnu gustinu i strukturu koštanog tkiva. Brojne studije su pokazale da neki lekovi mogu biti "štetni za kost" kao što su: glukokortikoidi, hormoni štitaste žlezde, antiepileptici, antidepresivi, aromatični inhibitori, gonadotropin oslobađajući agensi, kontraceptivi, antiretrovirusni lekovi, diuretici Henleove petlje, inhibitori protonske pumpe (IPP) i drugi. Uravnoteženi balans u primeni lekova za vreme dugotrajne terapije izazovan je i zahtevan posao lekara u primarnoj i sekundarnoj praksi i zavisi od njihove upućenosti o odnosu između koristi i štetnosti primenjenih medikamenata. Određivanje statusa skeleta pacijenta pre započinjanja terapije nekim od tzv. "lekova štetnih za kost", veoma je važno i omogućava individualan pristup u terapiji.Ključne reči: osteoporoza, dugotrajna medikacija, "lekovi štetni za kost" UvodKost čini osnovnu potporu ljudskom telu i za održavanje njene homeostaze mora postojati ravnoteža između stvaranja i razgradnje koštanog tkiva. Gustina i mikroarhitektonska struktura kostiju se tokom života menjaju i zavise od mnogih faktora. Poznato je da se svakih osam do deset godina koštano tkivo čitavog skeleta fiziološki zameni.Osteoporoza predstavlja sistemski poremećaj skeleta nastao kao posledica gubitka koštane mase [1] i mikroarhitekture kostiju, čije su najteže komplikacije prelomi. Ona je zapravo posledica disbalansa u remodelovanju kosti na račun pojačanih kataboličkih procesa (pojačana funkcija osteoklasta, a smanjena osteoblasta). Uobičajeno je da se mineralna gustina kostiju određuje dvostrukim rentgen-apsorpcionim (DXA) osteodenzimetrima pri čemu je bitno odrediti i broj odstupanja (SD) od srednjih vrednosti (DXA T-score), naročito za mlađe

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“…6 In addition, a history of contraceptive use or medications to treat gynecologic conditions was high (oral contraceptives, 75%; sex steroid hormones other than birth control pills, 37%). 6 Although oral contraceptives are generally believed to be neutral with regard to bone health, [7][8][9] depot medroxyprogesterone acetate (DMPA) 10 and GnRH agonists 7 are associated with decreases in BMD. The influence of these drug-related reductions in BMD on risk of fracture later in life has not been well established.…”

Section: Introductionmentioning

confidence: 99%

Bone Mineral Density Changes Associated With Pregnancy, Lactation, and Medical Treatments in Premenopausal Women and Effects Later in Life

Watts

Binkley

Owens

et al. 2021

Journal of Women's Health

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Bone mineral density (BMD) changes during the life span, increasing rapidly during adolescence, plateauing in the third decade of life, and subsequently entering a phase of age-related decline. In women, menopause leads to accelerated bone loss and an increase in fracture risk. Between peak bone mass attainment and menopause, BMD is generally stable and the risk of fracture is typically low. This time period is marked by life events such as pregnancy and lactation, which transiently decrease BMD, yet their long-term effects on fracture risk are less certain. BMD may also be altered by exposure to medications that affect bone metabolism (e.g., contraceptives, glucocorticoids, antidiabetic medications, antiepileptic drugs). Although oral contraceptives are often believed to be neutral with regard to bone health, depot medroxyprogesterone acetate (DMPA) and gonadotropinreleasing hormone (GnRH) agonists have been associated with decreases in BMD. Development of newer medical therapies, principally GnRH antagonists (e.g., ASP1707, elagolix, linzagolix, relugolix), for treatment of endometriosis-associated pelvic pain and heavy menstrual bleeding due to uterine fibroids has renewed interest in the short-and long-term impacts of changes in BMD experienced by premenopausal women. It is important to understand how these drugs influence BMD and put the findings into context with regard to measurement variability and naturally occurring factors that influence bone health. This review summarizes what is known about the effects on bone health pregnancy, lactation, and use of DMPA, GnRH agonists, and GnRH antagonists in premenopausal women and potential consequences later in life. ClinicalTrials.gov identifier: NCT03213457.

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Steroidal contraceptives and bone fractures in women: evidence from observational studies

Cited by 12 publications

References 50 publications

FSRH Guideline (January 2019, amended October 2023) Combined Hormonal Contraception

FSRH Guideline (January 2019, amended October 2023) Combined Hormonal Contraception

Osteoporoza prouzrokovana lekovima

Bone Mineral Density Changes Associated With Pregnancy, Lactation, and Medical Treatments in Premenopausal Women and Effects Later in Life

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