Fracture risk in very young women using combined oral contraceptives

Background: Little is known on fracture risk in young women using oral contraceptives. Study Design: Case-control study (64,548 cases, 193,641 controls). Results: Overall, no major association with risk of fracture was present. Only in a few age groups a limited increase (OR 1.1-1.5) was seen in those using low average doses (less than one tablet per day - i.e., intermittent use). Neither 20 nor >= 30 mcg per day of ethinylestradiol was associated with risk of fractures, while changing from 20 to >= 30 mcg per day or vice versa was associated with a limited increase in fracture risk (OR 1.1-1.4) in some age groups. Conclusions: In general, use of oral contraceptives in young women did not seem to be associated with an increased risk of fractures. The isolated increase seen in some strata with low average doses may be linked to factors associated with discontinuation of oral contraceptives rather than pharmacological effects. (c) 2008 Elsevier Inc. All rights reserved.