Although the influence of weight bearing activity on bone mass has been widely investigated in white women, few studies have been conducted in black, African populations. We investigated bone mineral density (BMD) in black South African women, with and without a history of load-carrying on the head. We also investigated whether load carrying may offer protection against low BMD in users of injectable progestin contraception (IPC). Participants were 32 black, South African women (22.4±3.2 yrs). Load carrying history was determined by questionnaire and interview and participants were grouped as load carriers (LC; n=18) or non load carriers (NLC; n=14). Ten women were using IPC and 6 were load-carriers. Total body (TB), lumbar spine (LS) and total hip (H) BMD were measured by dual energy X-ray absorptiometry. There were no differences in BMD between LC and NLC, and after controlling for age and BMI using two-tailed partial correlations. IPC users had lower BMD at all sites compared to non IPC users (p<0.05) and there were no associations between load carrying and BMD in this group. When IPC users were excluded from analysis, LC had higher LS BMD than NLC (p<0.005). Correlations were found between the weight of load carried and LS BMD (r=0.743, p<0.005), and between years of load carrying and LS and TB BMD (r=0.563, r=0.538 respectively; both p<0.05). Load carrying on the head may offer osteogenic benefits to the spine but these benefits did not appear in women using IPC.