Bones and Birth Control in Adolescent Girls

Area of Science:

• Reproductive Health
• Adolescent Medicine
• Bone Biology

Background:

• Peak bone mass acquisition during adolescence is critical for lifelong skeletal health.
• Contraceptive choices during adolescence may impact bone development.
• Understanding these effects is essential for recommending appropriate methods.

Purpose of the Study:

• To review normal bone acquisition in adolescents.
• To discuss methods for assessing adolescent bone health.
• To evaluate the impact of various contraceptives on bone health in adolescents and adults.

Main Methods:

• Systematic review of existing literature.
• Analysis of studies on adolescent bone acquisition.
• Evaluation of contraceptive effects on bone mineral density and fracture risk.

Main Results:

• Long-acting reversible contraceptives (LARCs) show no adverse effects on peak bone mass or future fracture risk.
• Oral contraceptives with >30 μg ethinyl estradiol are preferred over lower doses.
• Depo medroxyprogesterone acetate (DMPA) associated bone effects are reversible upon discontinuation.

Conclusions:

• LARCs are suitable first-line contraceptive options for adolescents.
• DMPA can be used by adolescents preferring it, as bone health effects are temporary.
• Contraceptive selection should consider bone health implications, but not exclude effective methods.