Rational use of oral contraceptives in the perimenopausal woman

Oral contraceptives have undergone extensive revision in their labeling over the past 10 years to remove warnings about cardiovascular and other risks and to highlight their noncontraceptive benefits. While these changes are becoming better known, the potential bone-sparing effects of oral contraceptives in the premenopausal and perimenopausal woman remain under-appreciated. Osteoporosis is a major health care problem worldwide in terms of both its associated morbidity and mortality and its economic impact. Although the benefits of postmenopausal hormone replacement therapy for the prevention and treatment of osteoporosis are generally recognized, little attention has been paid to strategies that might be used to maintain bone mass up to the time of menopause, at which time bone loss accelerates. An additional noncontraceptive benefit of oral contraceptives may be to maintain and build bone mass up to the time of menopause.