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BMD lower among women using oral contraceptives

WESTPORT, CT (Reuters Health) – The results of a population-based study by Canadian researchers show that premenopausal women who use oral contraceptives have lower bone mineral density (BMD), particularly for the trochanter and spine, compared with women who have never used oral contraceptives.

Dr. Jerilynn C. Prior from the University of British Columbia, Vancouver, and colleagues collected data for 524 women, with a mean age of 36.3 years, who participated in the Canadian Multicenter Osteoporosis Study. Among these women 454 (87%) had used oral contraceptives, according to the report in the October 16th issue of the Canadian Medical Association Journal.

After adjusting for age, body mass index and height, BMD in oral contraceptive users was 2.3% to 3.7% lower than in women who had never used oral contraceptives. BMD at the trochanter and spine was significantly lower for oral contraceptive users compared with nonusers.

Among women who had used oral contraceptives, BMD values for the spine were 1.03 g/cm² compared with 1.07 g/cm² in women who had never used oral contraceptives. BMD values for the trochanter were 0.70 g/cm² for oral contraceptive users and 0.72 g/cm², Dr. Prior's group found.

Lower BMD in oral contraceptive users was not related to the duration of oral contraceptive use or to the age when oral contraceptives were first used.

"This study revealed no effect of duration of oral contraceptive use on BMD: that fact makes a direct pharmacological effect of oral contraceptive use on BMD unlikely," Dr. Prior's team notes.

Dr. Prior and colleagues suggest that "it is possible that unmeasured environmental or other variables accounted for the BMD differences documented between women who had ever or never used oral contraceptives."

CMAJ 2001;165:1023-1029.

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