The study focused on Pill use by 14 to 18-year-old teenagers and looked at how bone density might change when a woman stops using the Pill. Delia Scholes, PhD, led the study and said that as hormones are a key component of bone health it made sense to study hormonal contraceptives. These are a major source of external hormones for women and the Pill is the most common birth control method worldwide.

A woman’s risk of fractures later in life is influenced by the bone mass she gains in her teens and her 20s, and this age group has the highest use of oral contraceptives. The study’s researchers measured hip, spine, and whole-body bone densities in 301 teenagers aged 14-18, and in 305 young adult women aged 19-30. They measured the bone densities of 389 participants using oral contraceptives with the two most commonly prescribed estrogen doses in Pills: 20-25 micrograms and 30-35 micrograms. These were compared to 217 similar women who were not using this method of contraception. Bone density measurements were taken at the start of the study, and every 6 months for 2 to 3 years. During that time, 172 oral contraceptive users stopped taking the medication, allowing the researchers to measure bone changes after Pill use was discontinued.

They found that after two years, teens who used the 30-35 microgram Pills showed about 1% less gain in bone density at both the spine and whole body sites than teens who did not use hormonal contraceptives. Any differences in bone density between users and non-users of oral contraceptives were less than 2%, and were seen only after two or more years of use, and only at some measured sites. At 12-24 months after stopping, young adult women who used either Pill dose showed small bone density losses at the spine compared to small gains in women who did not take oral contraceptives.

This may seem like a small loss of bone, but its impact in later life could be considerable. The researchers found that additional studies are needed, including looking at bone changes for a longer time after Pill use is discontinued so they can more accurately evaluate how oral contraceptive use is related to fracture risk.

For any young woman with a family history of osteoporosis, this finding is significant in terms of making a sensible contraceptive choice that will not adversely affect their long-term bone health. Additionally, taking extra precautions to optimise bone strength such as weight bearing exercise and ensuring progesterone levels are adequate would be a sensible plan throughout the teens and twenties.

With osteoporosis your bones become fragile and brittle and so are easily broken. As more severe bone loss occurs, then even minor accidents can result in fractures, most frequently in the spine, wrist, hip and pelvis. If the condition becomes advanced, and is untreated, then the vertebrae of the spine are prone to compression fractures, which affect surrounding nerves and organs. This also results in a loss of height for which the old nickname was ‘the dowager’s hump’ as it was frequently seen in the bent over posture of old ladies. It is also accompanied by chronic pain.

Risk Factors
Women are four times more likely than men to develop osteoporosis, and women over 55 are the most susceptible, although younger women can also be at risk depending on certain factors. It has also more recently been seen that more men are being diagnosed with osteoporosis. It is hard to know whether this is because they are now more susceptible because of the increased hormone levels in the water and food chain, or because they have not been diagnosed. As the greatest number of cases are seen in women, many doctors have not thought to link broken bones in men to osteoporosis. A simple scan by ultrasound can diagnose this and if a man is subject to bones breaking more easily then this would be a good check to make.

Knowing your medical history is important as osteoporosis often runs in families, but if this is not the case for you then it is the declining hormone levels as we age that are an important factor in whether or not you develop osteoporosis,. Both oestrogen and progesterone are essential for bone building and production of both these slow down as we get older. Normal bone tissue is broken down by cells called osteoclasts (a process which needs oestrogen) and rebuilt by osteoblasts. (which needs progesterone). As we age, the rate at which the bone is broken down exceeds that at which it is built up and this leads to bone loss.

It can also affect younger women who have had a surgical menopause through having a hysterectomy and also anyone who has undertaken severe dieting or has a history of anorexia or bulimia. There is a severe mineral loss involved in these conditions and during the teens and twenties and this can do permanent damage to the bones.

There are a number of ways to deal with osteoporosis and three of the important ones in the prevention and management of this condition are stress management, diet and exercise. Low levels of exercise can make the condition worse, and there are many good books on nutrition on this subject, but it will certainly be worsened by a diet high in animal protein, too much salt, heavy metal toxicity, cigarettes, numerous pregnancies and prolonged breast feeding.

Being aware of your own risk factors will enable you to take charge of your health and minimise the effect osteoporosis may have on you.