No link between progestogen-only contraceptives and premenopausal fracture risk

  • Kyvernitakis I & al.
  • Osteoporos Int
  • 6 May 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • This study found no association between progestogen-only contraception (progestogen-only pills [POPs] or levonorgestrel intrauterine devices [LNG-IUDs]) and premenopausal fracture risk.

Why this matters

  • Findings indicate that progestogen-only contraceptives may be considered a bone-safe contraceptive option for adolescents and adults.

Study design

  • This case-control study included 14,476 women with fractures (age range, 16-55 years) and 14,476 matched women without fractures (controls) in 169 general practices in the UK between January 2008 and December 2017.
  • Association between fracture risk and the use of progestin-only contraceptives (desogestrel, etynodiol, levonorgestrel, norethisterone, norgestrel) was evaluated.
  • Funding: None disclosed.

Key results

  • POPs were prescribed to 8.8% of women with fracture and 8.8% of women without fracture; LNG-IUDs were prescribed to 1.7% of women with fracture and 1.6% of women without fracture.
  • In the first logistic regression model (ever use vs. never use of progestogen-only contraceptives), no significant association was observed between POPs (OR, 0.95; 95% CI, 0.97-1.04; P=.289) or LNG-IUDs (OR, 0.99; 95% CI, 0.81-1.21; P=.903) and fracture incidence.
  • In the second regression model, treatment duration with POPs (OR, 1.00; 95% CI, 0.97-1.02; P=.830) or LNG-IUDs (OR, 0.94; 95% CI, 0.86-1.02; P=.138) did not show any significant effects on fracture incidence.
  • No significant association was seen between progestogen-only contraception and fracture incidence in different age groups.

Limitations

  • Study might have underestimated the fracture risk.