Adolescents with AN are at increased risk of unplanned pregnancies and bone loss due to low estrogen levels and intense use of efficient contraception. The negative impact of CHC on peak bone mass during adolescence might limit wider use in anorexic women. Another issue limiting CHC use is the concern that CHC-induced cyclic bleeding reduces the motivation for further weight gain and thus negatively impacts recovery. We wanted to find evidence-based answers about the impact of CHC on bone health and the course of the disease in adolescents with AN.
We performed a narrative review of the current literature investigating the effect of CHC or progestin-only contraceptives on bone density, body shape, and course of disease in young women with anorexia.
There is no evidence that CHC use aggravates the bone loss associated with AN. In long-term users, CHC exerts a protective effect. Anorexic women using CHC showed at least the same or a more significant weight gain than controls. Eating disorder attitudes did not worsen.
We conclude that there is no evidence that the use of CHC by AN patients harms bone density or the course of the disease.