Comparison of the skeletal effects of the progestogens desogestrel and levonorgestrel in oral contraceptive preparations in young women: controlled, open, partly randomized investigation over 13 cycles.
OBJECTIVE
This 12-month study was conducted to evaluate the skeletal effects of two monophasic oral contraceptives containing 20 mug of ethinylestradiol and 100 mug of levonorgestrel (LEVO) or 150 mug of desogestrel (DESO).


METHODS
Fifty-two women (18-24 years) were randomized into the DESO group or the LEVO group; 36 women served as controls. The areal bone mineral density (aBMD) of the femoral neck and the lumbar spine was evaluated by DXA, and parameters of bone geometry and volumetric bone mineral density (vBMD) were assessed by peripheral quantitative computed tomography at the distal radius and the tibia.


RESULTS
The LEVO group did not lose vertebral aBMD, whereas women in the DESO group lost 1.5%. At the distal radius and the tibia (shank level, 14%), LEVO induced an increase in total cross-sectional area, indicating increased periosteal bone formation. Radial trabecular vBMD declined by 1.4+/-1.8% in the DESO group, while it remained unchanged in the LEVO group.


CONCLUSIONS
Our study suggests that the skeletal effects of OC preparations may be influenced by progestogenic components in young women.
Hartard
Manfred
M
Department of Gynecology and Obstetrics, Faculty of Medicine, Klinikum Grosshadern, Working Group MusculoSkeletal Interactions, Ludwig Maximilians Universität, 81377 Munich, Germany. manfred.hartard@t-online.de
Kleinmond
Christine
C
Luppa
Peter
P
Zelger
Otto
O
Egger
Kathrin
K
Wiseman
Michael
M
Weissenbacher
Ernst Rainer
ER
Felsenberg
Dieter
D
Erben
Reinhold G
RG
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D015519:Bone Density / Q000187:drug effects*; D001842:Bone and Bones / Q000187:drug effects* / Q000378:metabolism; D024042:Collagen Type I / Q000097:blood; D003280:Contraceptives, Oral, Synthetic / Q000008:administration & dosage / Q000494:pharmacology*; D017135:Desogestrel / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage / Q000494:pharmacology*; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae / Q000187:drug effects; D015675:Osteocalcin / Q000097:blood; D010455:Peptides / Q000097:blood; D011884:Radius / Q000187:drug effects; D013977:Tibia / Q000187:drug effects; D014057:Tomography, X-Ray Computed
D024042:Collagen Type I; D003280:Contraceptives, Oral, Synthetic; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D015675:Osteocalcin; D016912:Levonorgestrel; D017135:Desogestrel; D000469:Alkaline Phosphatase