Pathophysiology of the potential adverse skeletal effects of oral contraceptives

It is generally established that a higher peak bone mass achieved in the early adulthood reduces the risk for osteoporosis after menopause. Adolescence and early adulthood are a critical time for skeletal growth and mineralization, and exposure to protective or detrimental factors during this period may influence peak bone mass and the subsequent risk for osteoporosis later in life.

It is still commonly believed that oral contraceptive (OC) use has no untoward or even a beneficial effect on bone mass in premenopausal women. However, during recent years there has been some evidence suggesting that use of low-dosed monophasic OC may actually impair bone mass accrual in adolescent and young women. Currently, the skeletal effects of OCs in young women are a matter of considerable debate. In light of the widespread use of hormonal contraceptives in adolescent girls and young women, and, thus, the socioeconomic impact any detrimental effect of OC use on bone mass accrual would have in the future, it is obvious that it is of paramount importance to elucidate further the pathophysiological mechanisms behind this potential negative effect of OC use on bone mass accrual.

It is the aim of the current experiments to lead to new insights into the biological effects of OC use on bone mass maintenance and accrual in an experimental ovariectomized rat model. A better understanding of mechanisms leading to potential adverse effects of OC intake on bone might ultimately lead to new concepts in the design of OCs, and also to new concepts for the treatment of postmenopausal osteoporosis with sex steroids. This work is performed in collaboration with Bayer Pharma AG.

3D reconstruction of proximal tibial metaphysis in sham-operated and OVX rats
3D reconstruction of proximal tibial metaphysis in sham-operated and OVX rats 1


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