Does Injectable Contraception Raise Fracture Risk?

Although the data might seem alarming, study methodology and biological plausibility raise questions about its validity.

Current use of depot medroxyprogesterone acetate (DMPA) contraceptive injections temporarily lowers ovarian estradiol production, prompting concerns that DMPA might raise fracture risk. Investigators used the U.K. General Practice Research Database to conduct a case-control study of 17,527 women (age range, 20–44) with first-time fractures diagnosed between 1995 and 2008 and 70,130 matched controls. Analysis was adjusted for smoking, body-mass index, and other potential confounders.

Eleven percent of women with fracture and 8% of controls had ever used DMPA. Compared with never use, current use of DMPA was associated with significantly higher risk for fracture (adjusted odds ratios, 1.2, 1.4, and 1.5 for women who received 1–2, 3–9, and ≥10 …

Reviewing Author

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Does Injectable Contraception Raise Fracture Risk?

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Reviewing Author