title: Effect of two kinds of different combined oral contraceptives use on bone mineral density in adolescent women.
abstract: BACKGROUND
  Steroid hormonal contraceptives are highly effective and widely used. Most studies have shown a negative effect of combined oral contraceptives (COCs) on the bone mineral density (BMD) of adolescents. The study was conducted to compare BMD among users of ethinylestradiol/desogestrel, users of ethinylestradiol/cyproterone acetate and nonhormonal control subjects in women aged 16-18 years.
  
  
  METHODS
  The study included 450 women 16-18 years of age. One hundred fifty women were using ethinylestradiol/desogestrel, 150 women were using ethinylestradiol/cyproterone acetate, and 150 women were using nonhormonal contraception as control subjects. BMD ofthe lumbar spine and femoral neck was obtained using dual-energy X-ray absorptiometry, and mean BMD changes in COCs users and nonusers were compared.
  
  
  RESULTS
  At 24 months of treatment, lumbar spine and femoral neck mean BMD values in women (n=127) who used ethinylestradiol/desogestrel were slightly lower compared with baseline, but these effects did not reach statistical significance (p=.837 and p=.630, respectively). The mean lumbar spine and femoral neck BMD values in women (n=134) who used ethinylestradiol/cyproterone acetate were slightly higher compared with baseline, but there was no statistical significance (p=.789 and p=.756, respectively). The increases in mean percent change in lumbar spine and femoral neck BMD in the ethinylestradiol/cyproterone acetate group were less than those in the control group (1.88% vs. 0.30% and 0.98% vs. 0.49%, respectively). There were no significant differences in mean BMD of the lumbar spine and femoral neck between the users of ethinylestradiol/desogestrel or ethinylestradiol/cyproterone acetate and nonusers (p>.05).
  
  
  CONCLUSIONS
  Our study indicates that 2 years of COCs therapy had no significant effect on bone density in adolescents, but it remains unknown whether therapy longer than 2 years has a significant adverse effect on the attainment of peak bone mass.
authors.affiliation: Key Laboratory for Improving Birth Outcome Technique, Shandong Provincial Institute of Science and Technology for Family Planning, Jinan, Shandong 250002, China. linggai5239@yahoo.com.cn
authors.forename: Ling
authors.initials: L
authors.lastname: Gai
authors.forename: Yifang
authors.initials: Y
authors.lastname: Jia
authors.forename: Meihua
authors.initials: M
authors.lastname: Zhang
authors.forename: Ping
authors.initials: P
authors.lastname: Gai
authors.forename: Sumei
authors.initials: S
authors.lastname: Wang
authors.forename: Hong
authors.initials: H
authors.lastname: Shi
authors.forename: Xiaojie
authors.initials: X
authors.lastname: Yu
authors.forename: Yonghong
authors.initials: Y
authors.lastname: Liu
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D041923:Adolescent Development / Q000187:drug effects*; D015519:Bone Density / Q000187:drug effects*; D001846:Bone Development / Q000187:drug effects*; D001862:Bone Resorption / Q000139:chemically induced / Q000000981:diagnostic imaging; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000187:drug effects*; D002681:China; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects*; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects; D017373:Cyproterone Acetate / Q000009:adverse effects*; D017135:Desogestrel / Q000009:adverse effects*; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000009:adverse effects*; D005260:Female; D005272:Femur Neck; D006801:Humans; D008159:Lumbar Vertebrae; D055118:Medication Adherence; D010352:Patient Dropouts
chemical_list: D003277:Contraceptives, Oral, Combined; D003278:Contraceptives, Oral, Hormonal; D004338:Drug Combinations; C442659:ethinyl estradiol-desogestrel combination; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; C032640:Cyproterone acetate, ethinyl estradiol drug combination; D017135:Desogestrel