Steroidal contraceptives: effect on bone fractures in women

Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures

“…Accordingly, key observations on the impact of each class on BMD and fracture risk are indicated in table 6, primarily in accordance with the findings of Panday et al in their 2014 review on medication-induced osteoporosis [81]. Recent literature reviews specific to each drug class are also cited to provide the reader with a source of more detailed current information [82][83][84][85][86][87][88][89][90][91]. A focus on three commonly used classes -glucocorticoids, androgen deprivation therapy and aromatase inhibitors -serves to illustrate the potential benefits of strategies to prevent osteoporosis induced by medicines.…”

Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures

“…Accordingly, key observations on the impact of each class on BMD and fracture risk are indicated in table 6, primarily in accordance with the findings of Panday et al in their 2014 review on medication-induced osteoporosis [81]. Recent literature reviews specific to each drug class are also cited to provide the reader with a source of more detailed current information [82][83][84][85][86][87][88][89][90][91]. A focus on three commonly used classes -glucocorticoids, androgen deprivation therapy and aromatase inhibitors -serves to illustrate the potential benefits of strategies to prevent osteoporosis induced by medicines.…”

Australian female athlete perceptions of the challenges associated with training and competing when menstrual symptoms are present

“…Similar to other research in athletes using contraceptives, 29 side effects were relatively common, with over one-third (37.9%) of contraceptive users reporting adverse events that they associated with contraceptive use, mostly related to mood changes. The long-term use of contraceptives, whether oral or steroidal, on factors such as bone density is still unclear, 30,31 However, there is evidence that oral contraceptive use during adolescence, when many athletes will begin using this for menstrual management, is related to a decrease in bone density 32 and an increased risk of depression. 33 Conversely, there appears to be a potential benefit in reducing ACL injuries with the use of the oral contraceptive pill 34,35 ; however, the quality of the evidence for this is low.…”

Prevalence of Low Bone Mass and Osteoporosis in Long-Term Users of the Injectable Contraceptive Depot Medroxyprogesterone Acetate

“…14 Nevertheless, longer periods of use, which obviously correlate with older age in users, may induce a reduction in BMD and consequently provoked low bone mass and osteoporosis and increasing fracture risk. There is no clear evidence regarding the relationship between DMPA use and an increased risk of fracture 3 despite the fact that some studies have shown a high risk of fracture in DMPA users compared with non-users. [15][16][17] However, there are some confounders that were not properly taken into account in those study populations, 1,3 and it is possible that the greater number of fractures in DMPA users could be accounted for by differences in the behavior of users compared to nonusers such as greater alcohol consumption, smoking and illicit drug abuse.…”

“…There is no clear evidence regarding the relationship between DMPA use and an increased risk of fracture 3 despite the fact that some studies have shown a high risk of fracture in DMPA users compared with non-users. [15][16][17] However, there are some confounders that were not properly taken into account in those study populations, 1,3 and it is possible that the greater number of fractures in DMPA users could be accounted for by differences in the behavior of users compared to nonusers such as greater alcohol consumption, smoking and illicit drug abuse. 16,18 A firm association has been established between these habits and a higher incidence of fractures in the appendicular skeleton, but not with fragility fractures in the axial skeleton.…”

Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures

“…Accordingly, key observations on the impact of each class on BMD and fracture risk are indicated in table 6, primarily in accordance with the findings of Panday et al in their 2014 review on medication-induced osteoporosis [81]. Recent literature reviews specific to each drug class are also cited to provide the reader with a source of more detailed current information [82][83][84][85][86][87][88][89][90][91]. A focus on three commonly used classes -glucocorticoids, androgen deprivation therapy and aromatase inhibitors -serves to illustrate the potential benefits of strategies to prevent osteoporosis induced by medicines.…”

Australian female athlete perceptions of the challenges associated with training and competing when menstrual symptoms are present

“…Similar to other research in athletes using contraceptives, 29 side effects were relatively common, with over one-third (37.9%) of contraceptive users reporting adverse events that they associated with contraceptive use, mostly related to mood changes. The long-term use of contraceptives, whether oral or steroidal, on factors such as bone density is still unclear, 30,31 However, there is evidence that oral contraceptive use during adolescence, when many athletes will begin using this for menstrual management, is related to a decrease in bone density 32 and an increased risk of depression. 33 Conversely, there appears to be a potential benefit in reducing ACL injuries with the use of the oral contraceptive pill 34,35 ; however, the quality of the evidence for this is low.…”

Prevalence of Low Bone Mass and Osteoporosis in Long-Term Users of the Injectable Contraceptive Depot Medroxyprogesterone Acetate

“…14 Nevertheless, longer periods of use, which obviously correlate with older age in users, may induce a reduction in BMD and consequently provoked low bone mass and osteoporosis and increasing fracture risk. There is no clear evidence regarding the relationship between DMPA use and an increased risk of fracture 3 despite the fact that some studies have shown a high risk of fracture in DMPA users compared with non-users. [15][16][17] However, there are some confounders that were not properly taken into account in those study populations, 1,3 and it is possible that the greater number of fractures in DMPA users could be accounted for by differences in the behavior of users compared to nonusers such as greater alcohol consumption, smoking and illicit drug abuse.…”

“…There is no clear evidence regarding the relationship between DMPA use and an increased risk of fracture 3 despite the fact that some studies have shown a high risk of fracture in DMPA users compared with non-users. [15][16][17] However, there are some confounders that were not properly taken into account in those study populations, 1,3 and it is possible that the greater number of fractures in DMPA users could be accounted for by differences in the behavior of users compared to nonusers such as greater alcohol consumption, smoking and illicit drug abuse. 16,18 A firm association has been established between these habits and a higher incidence of fractures in the appendicular skeleton, but not with fragility fractures in the axial skeleton.…”

Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures

“…Accordingly, key observations on the impact of each class on BMD and fracture risk are indicated in table 6, primarily in accordance with the findings of Panday et al in their 2014 review on medication-induced osteoporosis [81]. Recent literature reviews specific to each drug class are also cited to provide the reader with a source of more detailed current information [82][83][84][85][86][87][88][89][90][91]. A focus on three commonly used classes -glucocorticoids, androgen deprivation therapy and aromatase inhibitors -serves to illustrate the potential benefits of strategies to prevent osteoporosis induced by medicines.…”

Australian female athlete perceptions of the challenges associated with training and competing when menstrual symptoms are present

“…Similar to other research in athletes using contraceptives, 29 side effects were relatively common, with over one-third (37.9%) of contraceptive users reporting adverse events that they associated with contraceptive use, mostly related to mood changes. The long-term use of contraceptives, whether oral or steroidal, on factors such as bone density is still unclear, 30,31 However, there is evidence that oral contraceptive use during adolescence, when many athletes will begin using this for menstrual management, is related to a decrease in bone density 32 and an increased risk of depression. 33 Conversely, there appears to be a potential benefit in reducing ACL injuries with the use of the oral contraceptive pill 34,35 ; however, the quality of the evidence for this is low.…”

Prevalence of Low Bone Mass and Osteoporosis in Long-Term Users of the Injectable Contraceptive Depot Medroxyprogesterone Acetate

“…14 Nevertheless, longer periods of use, which obviously correlate with older age in users, may induce a reduction in BMD and consequently provoked low bone mass and osteoporosis and increasing fracture risk. There is no clear evidence regarding the relationship between DMPA use and an increased risk of fracture 3 despite the fact that some studies have shown a high risk of fracture in DMPA users compared with non-users. [15][16][17] However, there are some confounders that were not properly taken into account in those study populations, 1,3 and it is possible that the greater number of fractures in DMPA users could be accounted for by differences in the behavior of users compared to nonusers such as greater alcohol consumption, smoking and illicit drug abuse.…”

“…There is no clear evidence regarding the relationship between DMPA use and an increased risk of fracture 3 despite the fact that some studies have shown a high risk of fracture in DMPA users compared with non-users. [15][16][17] However, there are some confounders that were not properly taken into account in those study populations, 1,3 and it is possible that the greater number of fractures in DMPA users could be accounted for by differences in the behavior of users compared to nonusers such as greater alcohol consumption, smoking and illicit drug abuse. 16,18 A firm association has been established between these habits and a higher incidence of fractures in the appendicular skeleton, but not with fragility fractures in the axial skeleton.…”