Evidence map›Paper›PMID 39861124›Full record

ReviewPharmaceuticals (Basel, Switzerland)2025

Hormonal Contraception and Bone Metabolism: Emerging Evidence from a Systematic Review and Meta-Analysis of Studies on Post-Pubertal and Reproductive-Age Women.

Alice Tassi, Ambrogio P Londero, Anjeza Xholli, Giulia Lanzolla, Serena Bertozzi, Luca Savelli, Federico Prefumo, Angelo Cagnacci

Abstract readReview
In one paragraph

Review in Pharmaceuticals (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alice TassiObstetrics and Gynecology Unit, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy.ORCID 0000-0003-0249-6284
Ambrogio P LonderoDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health, University of Genoa, 16132 Genova, Italy.ORCID 0000-0001-6429-1220
Anjeza XholliAcademic Unit of Obstetrics and Gynecology, IRCCS Ospedale San Martino, 16132 Genoa, Italy.ORCID 0000-0001-8887-3823
Giulia LanzollaDepartment of Clinical and Experimental Medicine, Endocrinology Unit II, University of Pisa and University Hospital of Pisa, 56126 Pisa, Italy.ORCID 0000-0001-9933-4040
Serena BertozziBreast Unit, University Hospital of Udine, 33100 Udine, Italy.ORCID 0000-0003-1173-220X
Luca SavelliObstetrics and Gynecology Unit, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy.
Federico PrefumoObstetrics and Gynecology Unit, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy.ORCID 0000-0001-7793-714X
Angelo CagnacciDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health, University of Genoa, 16132 Genova, Italy.ORCID 0000-0003-2714-623X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesThis study aims to assess the effects of combined hormonal contraceptives (CHCs) on bone metabolism markers. It primarily measures osteocalcin and additionally examines other bone health markers, seeking to determine their responses to estrogen-progestogen treatments.

methodsThis study involved a comprehensive evaluation of the pertinent literature and a meta-analysis explicitly conducted on data describing women of reproductive age. The analysis encompassed accessible papers ranging to December 2024 (i.e., those listed in PubMed/Medline, Embase, Scopus, the Cochrane Database, International Clinical Trials Registry, and ClinicalTrials.gov). We examined published randomized controlled trials (RCTs) and prospective studies. The quality of the studies was assessed using the Cochrane tool for RCTs and the Newcastle-Ottawa Scale for prospective studies. The selected indicators for primary and secondary outcomes were ascertained by standardized mean change (SMC), displaying the difference between conditions before and after treatment. Trends were evaluated using meta-regressions.

resultsUltimately, 34 articles out of 1924 identified items met the inclusion criteria, covering 33 unique studies. In EE/E4 combinations, osteocalcin dropped significantly (SMC -0.54 (CI.95 -0.64/-0.43) and -0.43 (CI.95 -0.76/-0.10)). Similar effects were observed for other bone-formation and reabsorption markers, with less significant reductions observed in E2-containing CHC (e.g., alkaline phosphatase (bone) EE combinations, SMC -0.39 (CI.95 -0.67/-0.11); P1NP E2 combination, 0.12 (CI.95 -0.10/0.33); and EE combinations, -0.55 (CI.95 -0.83/-0.26)). The reduction patterns also exhibited differences according to the women's age (e.g., osteocalcin in EE combinations ≤21, SMC -0.63 (CI.95 -0.77/-0.49) and >21, SMC -0.42 (CI.95 -0.61/-0.24); alkaline phosphatase (bone) EE combinations ≤21, SMC -0.55 (CI.95 -0.86/-0.24) and >21, SMC -0.06 (CI.95 -0.47/0.35)). This analysis found that CHC maintains or reduces bone turnover in childbearing women, with effects varying by age and hormone combination. Moreover, bone-formation and reabsorption markers correlated positively to pro-androgenic progestins (

conclusionsThis study found that CHCs reduce bone turnover, with natural estrogens and androgenic progestins appearing to be more beneficial than EE and anti-androgenic types. These findings would potentially influence decisions relevant to CHC prescriptions during a woman's reproductive phases, emphasizing the need for additional research to tailor CHC usage to bone health.

Indexed as

androgenic effectbone turnoverestrogensosteocalcinprogestinsstandardized mean change

Identifiers

PMID39861124
PMCPMC11768253

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.