title: Steroidal contraceptive use is associated with lower bone mineral density in polycystic ovary syndrome.
abstract: Polycystic ovary syndrome (PCOS) is a common condition affecting reproductive-aged women with features including hyperandrogenism and menstrual irregularity frequently treated with hormonal steroidal contraceptives. Women with PCOS appear to have lower bone mineral density (BMD). While steroidal contraceptives may positively affect bone health, their effect on BMD in PCOS is not known. The aim of this study was to assess BMD in women with PCOS according to recent contraceptive use. A cross-sectional analysis of 95 pre-menopausal overweight or obese sedentary women with PCOS [age 29.4 ± 6.4 years, body mass index (BMI) 36.1 ± 5.3 kg/m(2)] who either recently took steroidal contraceptives (ceased 3 months prior) or were not taking steroidal contraceptives was conducted. Clinical outcomes included BMD, anthropometry, insulin, glucose, reproductive hormones, dietary intake and vitamin use. BMD was significantly lower for women who used contraceptives compared to those who did not (mean difference 0.06 g/cm(2) 95 % confidence interval -0.11, -0.02, p = 0.005). In regression models, lower BMD was independently associated with contraceptive use (β = -0.05, 95 % CI -0.094, -0.002, p = 0.042), higher testosterone (β = -0.03, 95 % CI -0.05, -0.0008, p = 0.043) and lower BMI (β = 0.006, 95 % CI 0.002, 0.01, p = 0.007) (r (2) = 0.22, p = 0.001 for entire model). We report for the first time that overweight and obese women with PCOS with recent steroidal contraceptive use had lower BMD in comparison to non-users independent of factors known to contribute to BMD. Whether this observation is directly related to steroidal contraceptive use or other factors requires further investigation.
authors.affiliation: The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, 55 King William Road, North Adelaide, SA, 5006, Australia. lisa.moran@adelaide.edu.au.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Moran
authors.affiliation: Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia.
authors.forename: R L
authors.initials: RL
authors.lastname: Thomson
authors.affiliation: Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia.
authors.forename: J D
authors.initials: JD
authors.lastname: Buckley
authors.affiliation: Fertility SA, Adelaide, SA, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Noakes
authors.affiliation: Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia.
authors.forename: P M
authors.initials: PM
authors.lastname: Clifton
authors.affiliation: The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, 55 King William Road, North Adelaide, SA, 5006, Australia.|Fertility SA, Adelaide, SA, Australia.
authors.forename: R J
authors.initials: RJ
authors.lastname: Norman
authors.affiliation: CSIRO Food and Nutrition, Adelaide, SA, Australia.
authors.forename: G D
authors.initials: GD
authors.lastname: Brinkworth
mesh_terms: D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D003278:Contraceptives, Oral, Hormonal
keywords: Bone mineral density; Contraceptive; Overweight; Polycystic ovary syndrome