No Link Between Progestogen-only Contraceptives and Premenopausal Fracture Risk

Sarfaroj Khan 

May 26, 2020


  • 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.


  • 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.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: