Health benefits – breast and bone

A. Glasier

Family Planning and Well Woman Services, Dean Terrace Clinic, Edinburgh, UK

The evidence for non-contraceptive benefits of hormonal contraception on breast and bone relates only to the combined oral contraceptive pill (COC). Most reviews on the topic state that the pill is associated with a reduced risk of benign breast disease (BBD) and that it is ‘good for bone’.

The data on BBD are scanty, somewhat old and, of course, observational. It seems counter-intuitive that COC use should be associated with an increased risk of breast cancer while at the same time preventing benign disease. The beneficial effects, if any, may be limited.

There are more data on the effect of COC on bone and they are more recent. However studies on the effects of contraception on bone mineral density are not easy to do since there are many confounding variables.

The quality of the research is very variable, but the better studies tend towards demonstrating no significant effect on the pill on bone mineral density. The limited amount of observational data is even more difficult to interpret but it is hard to conclude that use of the pill is associated with a reduced risk of osteoporotic fracture.

The benefits of combined hormonal contraception on breast and bone may well have been overstated.