Effect of two combinations of low-dose oral contraceptives on adolescent bone mass: A clinical trial with 2 years follow-up

Author(s)

Caldeirao, Talita Domingues ; Orsolini, Lilian Rodrigues ; da Silva, Carla Cristiane ; Bisi Rizzo, Anapaula da Conceicao ; Teixeira, Altamir Santos ; de Carvalho Nunes, Helio Rubens ; Lederer Goldberg, Tamara Beres

• Document type: Journal article
• Source: MEDICINE; v. 101, n. 37, p. 8-pg., 2022-09-16.

Abstract

Introduction: Most contraceptive combinations can interfere with the processes of bone formation and resorption. Aim: The aim of this study was to evaluate the effect of 2 combinations of low-dose oral hormonal contraceptives (20 mu g ethinyl estradiol [EE]/150 mg desogestrel [COC1] or 30 mu g EE/3 mg drospirenone [COC2]) on bone mass acquisition in adolescents over 2 years by means of bone densitometry and measurement of biomarkers of bone remodeling. Methods: Parallel-group, non-randomized controlled clinical trial of 127 adolescents divided into a control group and 2 groups receiving either COC1 or COC2. The participants were submitted to anthropometric assessment and evaluation of secondary sexual characteristics (Tanner criteria) and bone age. Bone densitometry by dual-energy X-ray absorptiometry and measurement of bone biomarkers (bone alkaline phosphatase, osteocalcin, and C-terminal telopeptide) were performed at baseline and after 24 months. Results: No significant differences in the variables analyzed were observed between COC1 or COC2 users and the control group at baseline. After 24 months, non-users had incorporated more bone mass (content and density) than either group of contraceptive users. This negative impact was more pronounced in the COC2 group than in the COC1 group. A significant reduction in the percentage values of bone alkaline phosphatase and osteocalcin was observed in users of oral contraceptives. Conclusion: Bone mass acquisition was compromised in adolescent users of combined hormonal contraceptives. The negative impact was more pronounced in adolescents using contraceptives that contain 30 mu g EE/3 mg drospirenone. (AU)

• FAPESP's process: 15/04040-2 - Bone mineral density and bone biomarkers assessment in adolescents user of low-dose combined oral contraceptive (ethinylestradiol 20µg/Desogestrel 150µg): 1 year follow-up
• Grantee: Tamara Beres Lederer Goldberg
• Support Opportunities: Regular Research Grants
• FAPESP's process: 11/05991-0 - The impact of body fat excess on bone densitometry and bone metabolims biomarkers: a study with overweight, obese and superobese adolescents
• Grantee: Tamara Beres Lederer Goldberg
• Support Opportunities: Regular Research Grants
• FAPESP's process: 07/07731-0 - Bone mineral density and content in healthy female adolescents between 10 and 20 years old and their relationship with bone formation and reabsorption markers
• Grantee: Tamara Beres Lederer Goldberg
• Support Opportunities: Regular Research Grants