No Link Between Progestogen-only Contraceptives and Premenopausal Fracture Risk

Sarfaroj Khan 

May 26, 2020

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.

Kyvernitakis I, Kostev K, Thomasius F, Stumpf U, Hadji P. Effect of progestogen-only contraception on premenopausal fracture risk: a case-control study. Osteoporos Int. 2020 May 06 [Epub ahead of print]. doi: 10.1007/s00198-020-05437-6. PMID: 32377808  View abstract 

This clinical summary first appeared on Univadis from Medscape.

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