Table 8

 Oligo/amenorrhoeic premenopausal women: no effect of oral contraceptives on bone mineral density

Study designReferenceNo of patientsOC exposureMeasurement of BMD/bone metabolismResults
OC, Oral contraceptive; BMD, bone mineral density; RCT, randomised controlled trial; EE, ethinyl oestradiol; DXA, dual energy x ray absorptiometry; NS, non-significant.
RCT (level 2b)Gibson6934 women with athletic oligo/amenorrhoeaOestrogen treated (1 mg oestriol +2 mg oestradiol, days 1–12; 1 mg oestriol+2 mg oestradiol +1 mg norethisterone acetate, days 13–22; 0.5 mg oestriol+1 mg oestradiol, days23–28)+1000 mg calcium carbonate (n = 10) v 1000 mg calcium carbonate (n = 14) v control (n = 10) for 18 monthsLumbar spine, Ward’s triangle, femoral neck, trochanteric region DXANS increase in BMD from baseline in oestrogen treated group
Cohort (level 2b)Gremion et al7030 female long distance runners (ages 19–37)9 OC users, 10 eumenorrhoeic non-users, 11 oligo/amenorrhoeic non-users over 12 monthsLumbar spine, proximal femur, midfemoral shaft DXA; osteocalcinNo change in BMD from baseline at any site in OC treated group; decrease in lateral lumbar spine BMD from baseline in oligo/amenorrhoeic group; lower osteocalcin levels in OC treated group than in other 2 groups