Our study demonstrated that progestogen-only oral and intrauterine contraceptives are not associated with fracture risk independent from age.
Purpose: The use of progestogen-only contraception, resulting in a hypoestrogenic state, has been associated with impaired bone acquisition and increased fracture risk. The aim of this large population-based study was to assess the fracture risk in association with the use of progestogen-only contraceptives (progestogen-only pills (POPs) and progestogen-containing IUDs (LNG-IUD)).
Methods: We identified 14,421 women between 16 and 55 years of age with a first-time diagnosis of fracture and matched them with 14,421 random controls using the Disease Analyzer Database.
Results: The results of the first adjusted logistic regression model (ever use vs. never use of progestogen-only contraceptives) revealed that there was no significant association between the use of POPs (OR = 0.98, 95% CI 0.90-1.07, p = 0.657) or LNG-IUDs (OR = 0.99, 95% CI 0.81-1.21, p = 0.945) and fracture incidence. Also, in the second regression model, we observed no effect of duration of use of POPs (OR = 1.01, 95% CI 0.98-1.03, p = 0.672) or LNG-IUDs (OR = 0.94, 95% CI 0.87-1.02, p = 0.177) on fracture occurrence. We also observed no effect in different age groups.
Conclusion: Our study results indicate that progestogen-only contraception (either POPs or LNG-IUPs) is not associated with fracture risk and may be considered a bone-safe option for adults and adolescents.
Keywords: Contraception; Fracture; Osteoporosis; Progesterone; Progestogen.