Bones and Birth Control in Adolescent Girls.J Pediatr Adolesc Gynecol 2020JP
Peak bone mass acquisition during adolescence is an important determinant of adult bone health. Knowledge about the effects of different contraceptives on peak bone mass acquisition could influence choice of method recommended. This review summarizes normal bone acquisition during adolescence, discusses methods of assessing bone health in this age group, and reviews the effects of different contraceptive options on bone health, both in adults and in adolescents. Based on the evidence, LARC does not appear to affect peak bone mass acquisition or future fracture risk and remains the first line contraceptive choice for adolescents. Oral contraceptives with doses of ethinyl estradiol > 30μg should be used in preference to lower dose preparations, and the adverse effects of DMPA on bone health are reversible on discontinuation of the medication. Concerns about bone health should not prevent use of DMPA in an adolescent who prefers this method.