ArticleThe Journal of clinical endocrinology and metabolism2011
Oral contraceptive use and bone density change in adolescent and young adult women: a prospective study of age, hormone dose, and discontinuation.
Article in The Journal of clinical endocrinology and metabolism, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- Adolescent use of combined hormonal contraception and peak bone mineral density accrual: A meta-analysis of international prospective controlled studies.Clinical endocrinology · 2019Pooled it
- Effects of Estrogen Replacement on Bone Geometry and Microarchitecture in Adolescent and Young Adult Oligoamenorrheic Athletes: A Randomized Trial.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2020Trial
- Are the Effects of Oral and Vaginal Contraceptives on Bone Formation in Young Women Mediated via the Growth Hormone-IGF-I Axis?Frontiers in endocrinology · 2020Trial
- Women in space: A review of known physiological adaptations and health perspectives.Experimental physiology · 2026Review
- Bone Health for Gynaecologists.Medicina (Kaunas, Lithuania) · 2025Review
- Prunes May Blunt Adverse Effects of Oral Contraceptives on Bone Health in Young Adult Women: A Randomized Clinical Trial.Current developments in nutrition · 2024Article
- U.S. Medical Eligibility Criteria for Contraceptive Use, 2024.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2024Article
- The Impact of Progesterone and Estrogen on the Tooth Mobility.Medicina (Kaunas, Lithuania) · 2023Article
- Quality of life and mental health in adolescent users of oral contraceptives. Results from the nationwide, representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS).Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2020Article
- Hormonal Contraception and Bone Health in Adolescents.Frontiers in endocrinology · 2020Review
- The safety of isotretinoin treatment in patients with bone fractures.Postepy dermatologii i alergologii · 2019Review
- Combined hormonal contraceptives use and bone mineral density changes in adolescent and young women in a prospective population-based Canada-wide observational study.Journal of musculoskeletal & neuronal interactions · 2018Observational
- Article
- Hyponatremia Is Associated With Increased Osteoporosis and Bone Fractures in a Large US Health System Population.The Journal of clinical endocrinology and metabolism · 2015Article
- Different health behaviours and clinical factors associated with bone mineral density and bone turnover in premenopausal women with and without type 1 diabetes.Diabetes/metabolism research and reviews · 2015Article
- Diminished bone strength is observed in adult women and men who sustained a mild trauma distal forearm fracture during childhood.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2014Article
- Effects of 17-α ethynyl estradiol on proliferation, differentiation & mineralization of osteoprecursor cells.The Indian journal of medical research · 2012Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
contextOral contraceptive (OC) use is common, but bone changes associated with use of contemporary OC remain unclear.
objectiveThe objective of the study was to compare bone mineral density (BMD) change in adolescent and young adult OC users and discontinuers of two estrogen doses, relative to nonusers. DESIGN AND
settingThis was a prospective cohort study, Group Health Cooperative.
participantsParticipants included 606 women aged 14-30 yr (50% adolescents aged 14-18 yr): 389 OC users [62% 30-35 μg ethinyl estradiol (EE)] and 217 age-similar nonusers; there were 172 OC discontinuers. The 24-month retention was 78%.
main outcome measureThe main outcome measure was BMD measured at 6-month intervals for 24-36 months.
resultsAfter 24 months, adolescents using 30-35 μg EE OCs, but not those using lower-dose OCs, had significantly smaller adjusted mean percentage BMD gains than nonusers at the spine [group means (95% confidence interval for between group differences) 1.32 vs. 2.26% (-1.89, -0.13%)] and whole body [1.45 vs. 2.03% (-1.29%, -0.13%)]. Adolescents who discontinued 30-35 μg EE OC showed significantly smaller gains than nonusers at the spine after 12 months [0.51 vs. 1.72% (-2.38%, -0.30%)]. Young adult OC users did not differ from nonusers. However, OC discontinuers of both doses differed significantly from nonusers at the spine 12 months after discontinuation [-1.32% < 30 μg EE, -0.92% 30-35 μg EE vs. +0.27% nonusers (-2.48, -0.54, and -1.94%, -0.55%, respectively)]. Results were similar for mean absolute BMD change (grams per square centimeter).
conclusionsBoth OC use and discontinuation were associated with BMD losses/smaller gains relative to nonusers (differences < 2% after 12-24 months for all skeletal sites). The clinical significance of these results regarding future fracture risk is unknown. Study of longer-term trends after discontinuation is needed.
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Registered trials
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