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Evidence Inconclusive about Hormonal Contraceptive Use and Bone Fracture Risk |
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Whether hormonal contraceptive use increases the risk of bone fracture later in life cannot be determined from current data. This was the conclusion of a recent Cochrane review conducted by Family Health International, with funding from USAID. Use of hormonal contraceptives has been associated with changes in bone density in women. However, whether these changes increase the risk of bone fracture later in life remains undetermined. The authors reviewed 11 randomized controlled trials, none of which had bone fracture as an outcome. However, most had bone density as an outcome. Authors found that birth control methods with both estrogen and progestin did not appear to harm bone health. Two placebo-controlled trials showed bone mineral density increases when the progestin-only injectable depot-medroxyprogesterone acetate (DMPA) was used with an estrogen supplement. They showed decreases with DMPA plus placebo; however, whether this decrease is clinically important could not be determined. Results for progestin-only implants were inconsistent. While progestin-only injectables and implants may affect bone density, they provide effective birth control for women who want a long-term method. They are also considered appropriate for women who should avoid estrogen for medical reasons. The authors recommend that health care providers and women weigh the risks, costs, and benefits of each type when choosing to use a hormonal contraceptive. Read more about this review. Source
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