An endocrine perspective on menstrual suppression for adolescents: achieving good suppression while optimizing bone health

Amit Lahoti; Christine Yu; Preneet Cheema Brar; Austin Dalgo; Evgenia Gourgari; Rebecca Harris; Manmohan K Kamboj; Seth Marks; Radha Nandagopal; Laura Page; Vandana Raman; Danielle G Reynolds; Kyriakie Sarafoglou; Carrie Terrell; Takara L Stanley

doi:10.1515/jpem-2020-0539

An endocrine perspective on menstrual suppression for adolescents: achieving good suppression while optimizing bone health

J Pediatr Endocrinol Metab. 2021 Aug 13;34(11):1355-1369. doi: 10.1515/jpem-2020-0539. Print 2021 Nov 25.

Authors

Amit Lahoti¹, Christine Yu², Preneet Cheema Brar³, Austin Dalgo⁴, Evgenia Gourgari⁵, Rebecca Harris⁶, Manmohan K Kamboj⁷, Seth Marks⁸, Radha Nandagopal⁹, Laura Page¹⁰, Vandana Raman¹¹, Danielle G Reynolds¹², Kyriakie Sarafoglou^{13

14}, Carrie Terrell¹⁵, Takara L Stanley¹⁶

Affiliations

¹ Pediatric Endocrine Division, Le Bonheur Children's Hospital and University of Tennessee Health Science Center, Memphis, TN, USA.
² Section of Adult and Pediatric Endocrinology, Diabetes, & Metabolism, University of Chicago, Chicago, IL, USA.
³ Division of Pediatric Endocrinology and Diabetes, NYU Grossman School of Medicine, New York, NY, USA.
⁴ Center for Bioethics and Health Equity, Le Bonheur Children's Hospital and University of Tennessee Health Science Center, Memphis, TN, USA.
⁵ Pediatric Endocrinology Division, Department of Pediatrics, Georgetown University, Washington, DC, USA.
⁶ Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA.
⁷ Section of Endocrinology, Department of Pediatrics, Nationwide Children's Hospital at The Ohio State University, Columbus, OH, USA.
⁸ Section of Pediatric Endocrinology and Metabolism, Department of Pediatrics and Child Health, Children's Hospital HSC Winnipeg, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
⁹ Department of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA.
¹⁰ Division of Endocrinology, Department of Pediatrics, Duke University, Durham, NC, USA.
¹¹ University of Utah, Salt Lake City, UT, USA.
¹² Diabetes and Endocrinology Center, University of South Florida, Tampa, FL, USA.
¹³ Division of Pediatric Endocrinology, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA.
¹⁴ Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, MN, USA.
¹⁵ Division of General Obstetrics, Gynecology, Midwifery and Family Planning at the University of Minnesota Medical School, Minneapolis, MN, USA.
¹⁶ Pediatric Endocrine Unit and Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

PMID: 34388330
DOI: 10.1515/jpem-2020-0539

Abstract

Suppression of menstruation and/or ovarian function in adolescent girls may be desired for a variety of reasons. Numerous medical options exist. The choice of the appropriate modality for an individual patient depends on several factors based on differences in the efficacy of achieving menstrual suppression as well as in their side effect profiles. Adolescence is also a period of bone mass accrual in girls, and several of these modalities may negatively influence peak bone mass. This review focuses on the efficacy of achieving menstrual suppression and the effect on bone health of the various options through an overview of the current literature and also highlights areas in need of further research.

Keywords: adolescents; amenorrhea; bone health; contraception; ethics; menstrual suppression; osteoporosis.

Publication types

Review

MeSH terms

Adolescent
Bone Density / drug effects*
Contraceptives, Oral, Combined / administration & dosage*
Female
Humans
Menstruation / drug effects*

Substances

Contraceptives, Oral, Combined