Progestogen-only contraception and bone mineral density: a systematic review

Questions have been raised about the effects of progestogen-only contraceptive use on bone health, particularly among young women who have not yet reached peak bone mass and perimenopausal women who may be starting to lose bone mass. We conducted a systematic review that evaluated the association be...

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Bibliographic Details
Published in:Contraception (Stoneham) 2006-05, Vol.73 (5), p.470-487
Main Authors: Curtis, Kathryn M., Martins, Summer L.
Format: Article
Language:English
Subjects:
Age Factors
Biological and medical sciences
Birth control
Bone Density - drug effects
Bone mineral density
Contraception
Contraceptives, Oral, Hormonal - adverse effects
Drug toxicity and drugs side effects treatment
Female
Fracture
Fractures, Bone - etiology
Gynecology. Andrology. Obstetrics
Hormonal contraception
Humans
Medical sciences
Menopause
Pharmacology. Drug treatments
Progesterone Congeners - adverse effects
Progestogen
Systematic review
Toxicity: osteoarticular system
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Summary:Questions have been raised about the effects of progestogen-only contraceptive use on bone health, particularly among young women who have not yet reached peak bone mass and perimenopausal women who may be starting to lose bone mass. We conducted a systematic review that evaluated the association between progestogen-only contraceptive use and fracture risk or bone mineral density (BMD). We identified 39 articles from MEDLINE and EMBASE, published through July 2005. One study reported that depot medroxyprogesterone acetate (DMPA) users were more likely to experience stress fractures than nonusers; this association was not statistically significant after controlling for baseline bone density. In cross-sectional studies, the mean BMD in DMPA users was usually below that of nonusers, but within 1 SD. In longitudinal studies, BMD generally decreased more over time among DMPA users than among nonusers, but women gained BMD upon discontinuation of DMPA. Limited evidence suggested that use of progestogen-only contraceptives other than DMPA did not affect BMD.
ISSN:0010-7824
1879-0518
DOI:10.1016/j.contraception.2005.12.010