Steroidal contraceptive use is associated with lower bone mineral density in polycystic ovary syndrome

Lisa J. Moran, R. L. Thomson, J. D. Buckley, Manny Noakes, Peter M Clifton, Robert J Norman, Grant D Brinkworth

Research output: Contribution to journalLetterResearchpeer-review

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/m2] 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/cm2 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) (r2 = 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.

Original languageEnglish
Pages (from-to)811-815
Number of pages5
JournalEndocrine
Volume50
Issue number3
DOIs
Publication statusPublished - 1 Dec 2015

Keywords

  • Bone mineral density
  • Contraceptive
  • Overweight
  • Polycystic ovary syndrome

Cite this

Moran, L. J., Thomson, R. L., Buckley, J. D., Noakes, M., Clifton, P. M., Norman, R. J., & Brinkworth, G. D. (2015). Steroidal contraceptive use is associated with lower bone mineral density in polycystic ovary syndrome. Endocrine, 50(3), 811-815. https://doi.org/10.1007/s12020-015-0625-7
Moran, Lisa J. ; Thomson, R. L. ; Buckley, J. D. ; Noakes, Manny ; Clifton, Peter M ; Norman, Robert J ; Brinkworth, Grant D. / Steroidal contraceptive use is associated with lower bone mineral density in polycystic ovary syndrome. In: Endocrine. 2015 ; Vol. 50, No. 3. pp. 811-815.
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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/m2] 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/cm2 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) (r2 = 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.",
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Moran, LJ, Thomson, RL, Buckley, JD, Noakes, M, Clifton, PM, Norman, RJ & Brinkworth, GD 2015, 'Steroidal contraceptive use is associated with lower bone mineral density in polycystic ovary syndrome' Endocrine, vol. 50, no. 3, pp. 811-815. https://doi.org/10.1007/s12020-015-0625-7

Steroidal contraceptive use is associated with lower bone mineral density in polycystic ovary syndrome. / Moran, Lisa J.; Thomson, R. L.; Buckley, J. D.; Noakes, Manny; Clifton, Peter M; Norman, Robert J; Brinkworth, Grant D.

In: Endocrine, Vol. 50, No. 3, 01.12.2015, p. 811-815.

Research output: Contribution to journalLetterResearchpeer-review

TY - JOUR

T1 - Steroidal contraceptive use is associated with lower bone mineral density in polycystic ovary syndrome

AU - Moran, Lisa J.

AU - Thomson, R. L.

AU - Buckley, J. D.

AU - Noakes, Manny

AU - Clifton, Peter M

AU - Norman, Robert J

AU - Brinkworth, Grant D

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N2 - 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/m2] 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/cm2 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) (r2 = 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.

AB - 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/m2] 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/cm2 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) (r2 = 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.

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KW - Contraceptive

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