Table 8 Oligo/amenorrhoeic premenopausal women: no effect of oral contraceptives on bone mineral density.

Study design	Reference	No of patients	OC exposure	Measurement of BMD/bone metabolism	Results
RCT (level 2b)	Gibson69	34 women with athletic oligo/amenorrhoea	Oestrogen treated (1 mg oestriol +2 mg oestradiol, days 1–12; 1 mg oestriol+2 mg oestradiol +1 mg norethisterone acetate, days 13–22; 0.5 mg oestriol+1 mg oestradiol, days23–28)+1000 mg calcium carbonate (n = 10) v 1000 mg calcium carbonate (n = 14) v control (n = 10) for 18 months	Lumbar spine, Ward's triangle, femoral neck, trochanteric region DXA	NS increase in BMD from baseline in oestrogen treated group
Cohort (level 2b)	Gremion et al70	30 female long distance runners (ages 19–37)	9 OC users, 10 eumenorrhoeic non‐users, 11 oligo/amenorrhoeic non‐users over 12 months	Lumbar spine, proximal femur, midfemoral shaft DXA; osteocalcin	No change in BMD from baseline at any site in OC treated group; decrease in lateral lumbar spine BMD from baseline in oligo/amenorrhoeic group; lower osteocalcin levels in OC treated group than in other 2 groups

OC, Oral contraceptive; BMD, bone mineral density; RCT, randomised controlled trial; EE, ethinyl oestradiol; DXA, dual energy x ray absorptiometry; NS, non‐significant.