A prospective, controlled study of the effects of hormonal contraception on bone mineral density☆
Section snippets
Materials and methods
All women recruited between May 16, 1996, and January 20, 1999, who had undergone a baseline bone scan as part of a larger contraceptive study, were eligible to participate. Subjects were between 18 and 33 years of age and white, black, Asian, or Hispanic. Because of the funding source (Department of Defense), all women were required to meet minimal criteria for entry into the Armed Forces (graduated high school or had GED, no felony arrests, within 36% of ideal body weight for height, and free
Results
A total of 275 women who met all inclusion criteria were enrolled in the study. Of these, 96 chose injectable contraception and were administered DMPA, whereas 179 women elected to initiate oral contraception and were randomly assigned to receive either norethindrone-containing (n = 87) or desogestrel-containing (n = 92) pills. Thirty-nine percent (107 of 275) of women discontinued their hormonal method before their 12-month visit. Of the 168 women who continued their method, 31 failed to
Discussion
We observed that use of DMPA for 12 months has an adverse effect on BMD, compared with OCs or nonhormonal methods. On average, women who used DMPA experienced approximately a 2.7% loss in BMD compared with a 0.37% loss in those not using hormonal contraception and small gains among OC users of 0.33% and 2.33%, respectively, for users of desogestrel- and norethindrone-containing pills. The mechanism of the effect of DMPA on BMD is unknown. However, studies have shown that DMPA users have
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Reproductive and hormonal factors and the risk for osteoporosis
2020, Marcus and Feldman’s OsteoporosisComparison of long-term use of combined oral contraceptive after gonadotropin-releasing hormone agonist plus add-back therapy versus dienogest to prevent recurrence of ovarian endometrioma after surgery
2019, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :However, when followed by long-term COC, BMD did not deteriorate at 12 and 24 months, and actually improved from 6 months. This finding is consistent with randomized studies reporting that COCs do not exert any clinically significant effect on BMD in the general population [22–25]. Meanwhile, lumbar spine BMD significantly decreased during the first 6 months of DNG treatment (-2.3%), consistent with previous Asian studies reporting BMD decrease from -1.7% to -2.8% within a year of DNG use [15,26].
No. 329-Canadian Contraception Consensus Part 4 of 4 Chapter 9: Combined Hormonal Contraception
2017, Journal of Obstetrics and Gynaecology CanadaNo. 329-Canadian Contraception Consensus (Part 4 of 4): Chapter 9 - Combined hormonal contraception
2017, Journal of Obstetrics and Gynaecology CanadaCanadian Contraception Consensus (part 3 of 4): Chapter 8 - Progestin-only contraception
2016, Journal of Obstetrics and Gynaecology CanadaCitation Excerpt :Bien que certaines études transversales et longitudinales aient démontré que l’AMPR n’entraînait aucun effet indésirable sur la densité minérale osseuse134,135, la plupart des études signalent une baisse de la DMO chez les utilisatrices d’AMPR136–145. Par comparaison avec les non-utilisatrices, les utilisatrices d’AMPR connaissent une baisse de leur DMO au niveau de la hanche et de la colonne de l’ordre de 0,5 %-3,5 % après un an d’utilisation et de 5,7 %-7,5 % après deux ans 132,139,141,143,144,146. La perte la plus importante survient au cours des première et deuxième années d’utilisation; par la suite, les taux de DMO semblent se stabiliser147–149.
Canadian Contraception Consensus (Part 3 of 4): Chapter 8 - Progestin-Only Contraception
2016, Journal of Obstetrics and Gynaecology Canada
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This study was supported by the US Army Medical Research and Material Command under contract No. DAMD17-96-C-6113, and by the National Osteoporosis Foundation.
The views, opinions, and/or findings contained in this report are those of the authors and should not be construed as an official Department of the Army position, policy, or decision unless so designated by other documentation. The investigators adhered to the policies regarding the protection of human subjects as described by 45 CFR 46 and 32 CFR 219 (Protection of Human Subjects).
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Dr. Rickert is currently at the Department of Pediatrics, The Mount Sinai School of Medicine, New York, New York; and Dr. Thomas is in private practice in Oakland, California.