Emma L Ivansson,Therese Johansson,Torgny Karlsson,Åsa Johansson
{"title":"Oral contraceptive use increases bone density and reduces the risk of osteoporosis.","authors":"Emma L Ivansson,Therese Johansson,Torgny Karlsson,Åsa Johansson","doi":"10.1007/s10654-025-01273-2","DOIUrl":null,"url":null,"abstract":"Osteoporotic fractures, largely resulting from reduced estrogen levels after menopause and subsequent bone loss, are a leading cause of disability among older women. Although oral contraceptive pills (OCPs) contain estrogen, their long-term impact on bone health and osteoporosis risk remain uncertain. Here, we assessed the effect of OCP use on bone mineral density (BMD) and osteoporosis using data from 257,185 women from the UK Biobank, born 1936-1970. Time-dependent Cox regression was used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for osteoporosis, while multivariable linear regression was used to assess the effect of OCP use on BMD, measured as T-scores in standard deviation units based on quantitative ultrasound of the calcaneus. By the end of follow-up in 2020, 7.6% of the participants had received an osteoporosis diagnosis. The rate of osteoporosis was lower among ever OCP users (HR = 0.86; 95% CI 0.83-0.89; P = 2.8 × 10-17). OCP use was also associated with a higher BMD T-score (0.052; 0.038-0.067; P = 2.1 × 10-12) with an increasing effect with longer use. Use of OCPs for 0-1 years had no significant effect on BMD (P = 0.081). However, longer durations were associated with increased BMD T-scores compared to never users: 2-5 years (0.046; 0.027-0.065, P = 2.2 × 10-6), 6-10 years (0.062; 0.043-0.080; P = 3.5 × 10-12), 11-15 years (0.062; 0.042-0.081; P = 3.2 × 10-12) and 16 + years (0.064; 0.044-0.083; P = 1.2 × 10-10). We found prior OCP use to be associated with higher BMD and a reduced risk of osteoporosis, potentially offering long-term benefits and suggesting that OCP use could reduce osteoporotic complications in older women.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"72 1","pages":""},"PeriodicalIF":5.9000,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10654-025-01273-2","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Osteoporotic fractures, largely resulting from reduced estrogen levels after menopause and subsequent bone loss, are a leading cause of disability among older women. Although oral contraceptive pills (OCPs) contain estrogen, their long-term impact on bone health and osteoporosis risk remain uncertain. Here, we assessed the effect of OCP use on bone mineral density (BMD) and osteoporosis using data from 257,185 women from the UK Biobank, born 1936-1970. Time-dependent Cox regression was used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for osteoporosis, while multivariable linear regression was used to assess the effect of OCP use on BMD, measured as T-scores in standard deviation units based on quantitative ultrasound of the calcaneus. By the end of follow-up in 2020, 7.6% of the participants had received an osteoporosis diagnosis. The rate of osteoporosis was lower among ever OCP users (HR = 0.86; 95% CI 0.83-0.89; P = 2.8 × 10-17). OCP use was also associated with a higher BMD T-score (0.052; 0.038-0.067; P = 2.1 × 10-12) with an increasing effect with longer use. Use of OCPs for 0-1 years had no significant effect on BMD (P = 0.081). However, longer durations were associated with increased BMD T-scores compared to never users: 2-5 years (0.046; 0.027-0.065, P = 2.2 × 10-6), 6-10 years (0.062; 0.043-0.080; P = 3.5 × 10-12), 11-15 years (0.062; 0.042-0.081; P = 3.2 × 10-12) and 16 + years (0.064; 0.044-0.083; P = 1.2 × 10-10). We found prior OCP use to be associated with higher BMD and a reduced risk of osteoporosis, potentially offering long-term benefits and suggesting that OCP use could reduce osteoporotic complications in older women.
期刊介绍:
The European Journal of Epidemiology, established in 1985, is a peer-reviewed publication that provides a platform for discussions on epidemiology in its broadest sense. It covers various aspects of epidemiologic research and statistical methods. The journal facilitates communication between researchers, educators, and practitioners in epidemiology, including those in clinical and community medicine. Contributions from diverse fields such as public health, preventive medicine, clinical medicine, health economics, and computational biology and data science, in relation to health and disease, are encouraged. While accepting submissions from all over the world, the journal particularly emphasizes European topics relevant to epidemiology. The published articles consist of empirical research findings, developments in methodology, and opinion pieces.