Oral Contraceptives May Reduce Fracture Risk

Women who had taken oral contraceptives for more than 5 years had the lowest risk for fracture.

Oral contraception use was significantly associated with a lower fracture risk in women, particularly in younger women taking oral contraceptives (OC) for more than 1 year, according to a recent retrospective study.

A team of researchers from Germany and France analyzed 6485 women in 135 physicians’ offices in the United Kingdom who sustained fractures between January 2010 and December 2015. The patients’ mean age was 37.8 years. They were matched to a control group (n=6485) based on age, index year, and follow-up to determine the relationship between combination OC use and fracture risk.


The researchers found an association between reduced fracture risk and OC use (odds ratio [OR], 0.81; 95% CI, 0.74-0.90; P <.001), with patients in the 18- to 25-year-old group (OR, 0.62; 95% CI, 0.48-0.79; P <.001) as well as the 26- to 35-year-old group (OR, 0.65; 95% CI, 0.52-0.81; P <.001) having the lowest risk for fracture.

Patients who had taken OC for >5 years had the lowest fracture risk (OR, 0.62; 95% CI, 0.53-0.74; P <.001), with patients in the 4- to 5-year (OR, 0.79; 95% CI, 0.65-0.94; P =.008) and 2- to 3-year (OR, 0.81; 95% CI, 0.71-0.93; P =.003) groups also having a reduced risk for fracture.

In addition, the following variables significantly increased the risk for fracture: being an active smoker compared with being a nonsmoker (OR, 1.66; 95% CI, 1.49-1.84; P <.001), being an ex-smoker compared with being a current smoker (OR, 1.26; 95% CI, 1.11-1.47; P <.001), alcohol abuse (OR, 2.28; 95% CI, 1.64-3.16; P <.001), diabetes (OR, 1.35; 95% CI, 1.04-1.79; P =.026), and having a bone density disorder (OR, 1.93; 95% CI, 1.13-3.31; P =.017), epilepsy (OR, 1.40; 95% CI, 1.00-1.96; P =.049), or anorexia nervosa (OR, 1.31; 95% CI, 1.12-1.55; P =.001).

“Considering that bone fracture is less likely to affect younger women and that the majority of the existing studies focus on bone density and not on bone fracture, our findings indicating a decreased risk of bone fracture in women using OC warrant close attention,” the researchers wrote. “A follow-up investigation of the impact of OC use on fracture risk depending on OC dose is needed to gain further knowledge in this area.”

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Dombrowski S, Jacob L, Hadji P, Kostev K. Oral contraceptive use and fracture risk — a retrospective study of 12,970 women in the UK [published online April 13, 2017]. Osteoporos Int. doi:10.1007/s00198-017-4036-x