Use of hormonal contraception in adolescents: skeletal health issues
| Autor: | Lama Tolaymat, Andrew M Kaunitz |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Adolescent medicine.drug_class Population Physiology Medroxyprogesterone Acetate Intrauterine device Young Adult Bone Density Medicine Medroxyprogesterone acetate Humans Young adult education Gynecology education.field_of_study Bone Development business.industry Obstetrics and Gynecology Adolescent Development Bone Diseases Metabolic Contraceptives Oral Combined Family planning Hormonal contraception Pill Female business Progestin hormones hormone substitutes and hormone antagonists medicine.drug |
| Zdroj: | Current opinion in obstetricsgynecology. 21(5) |
| ISSN: | 1473-656X |
| Popis: | PURPOSE OF REVIEW: To summarize the current literature regarding the effects of hormonal contraceptives on adolescents bone health. RECENT FINDINGS: Use of progestin-only pills implant and progestin-releasing intrauterine device is associated with low systemic progestin levels that do not appear to impact ovarian estradiol production or bone mineral density (BMD). In contrast higher systemic progestin levels associated with the use of depot medroxyprogesterone acetate and combination oral contraceptives suppress ovarian estradiol production and reduce acquisition of BMD in teenagers and young adult women who use injectable and oral contraceptives. Although BMD is a predictor of the risk of fracture in postmenopausal women the clinical implications of BMD changes in teenagers and young women are unknown. Following the hypoestrogenemia associated with the use of depot medroxyprogesterone acetate or lactation BMD deficits have been found to completely reverse. Although BMD data following combination oral contraceptive use in adolescents is sparse observations suggest that rapid and complete reversibility of BMD deficits is likely. SUMMARY: Although more data on skeletal health outcomes following the use of oral and injectable contraceptives would be welcomed theoretic concerns regarding the impact of depot medroxyprogesterone acetate and combination oral contraceptive use on adolescent and young women should not restrict the initiation or continuation of these important contraceptive methods. |
| Databáze: | OpenAIRE |
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