Estrogen-progestin contraceptive use during adolescence prevents bone mass acquisition: a 4-year follow-up study.
BACKGROUND
Estrogen-progestin contraception may affect estrogen production and alter the development of peak bone mass.


METHODS
A 4-year follow-up with 122 adolescent women aged 12-19 years. The data were divided into three groups based on estrogen-progestin contraceptive (EPC) use: (i) nonusers (n=52), (ii) 1-2 years of use (n=24) and (iii) use for more than 2 years (n=46). The estrogen dose of the preparations was < or =35 mcg. Height, weight, and the amount of exercise (ratio of work metabolic rate, h/week) as well as bone mineral content (BMC) of lumbar spine and femoral neck were measured repeatedly.


RESULTS
There was a significant trend showing less of an increase in the mean adjusted BMC of lumbar spine in the group of adolescent women who had used EPC for more than 2 years compared with the two other groups. In the mean adjusted BMC of the femoral neck, there was a significant trend of a smaller increase in EPC users for more than 2 years compared with 1-2 years of use.


CONCLUSIONS
Long-term EPC with low-dose estrogen preparations seems to suppress normal bone mineral accrual in adolescent women.
Pikkarainen
Essi
E
Sports and Exercise Medicine Unit, Department of Physiology, Paavo Nurmi Centre, University of Turku, 20520 Turku, Finland. esanra@utu.fi
Lehtonen-Veromaa
Marjo
M
Möttönen
Timo
T
Kautiainen
Hannu
H
Viikari
Jorma
J
D015502:Absorptiometry, Photon; D000293:Adolescent; D015519:Bone Density / Q000187:drug effects*; D002113:Calcification, Physiologic / Q000187:drug effects*; D002648:Child; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects*; D004967:Estrogens / Q000009:adverse effects*; D005260:Female; D005272:Femur Neck / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D011372:Progestins / Q000009:adverse effects*; D055815:Young Adult
D003277:Contraceptives, Oral, Combined; D004967:Estrogens; D011372:Progestins