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Contraception. 1997 Jul;56(1):1-3.

Bone mineral density in long-term depot medroxyprogesterone acetate acceptors.

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1
Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Abstract

The study of bone density in long-term DMPA users is reported. The aims were to study and compare bone density in long-term DMPA users with intrauterine device (IUD) users. Fifty current users of DMPA with a minimum 36 months previous use were compared to 50 current IUD users as control. The bone mineral density was measured by dual energy x-ray absorptiometry (DEXA) at the non-dominant distal and ultradistal forearm. Serum estradiol was measured by microparticle enzyme immunoassay technique in both groups. Age, income, weight, height, BMI, and parity of both groups were matched. The mean bone mineral density of distal forearm in DMPA and IUD users was 0.48 +/- 0.05 g/cm2 in both groups. The mean bone mineral density of ultradistal forearm was 0.38 +/- 0.06 g/cm2 in DMPA users and 0.4 +/- 0.05 g/cm2 in IUD users. No differences in mean bone mineral density of distal and ultradistal forearm between DMPA and IUD users was demonstrated (95% CI -0.02, 0.02 and -0.04, 0.001, respectively). However, the serum estradiol levels were significantly different between DMPA and IUD users (95% CI -122, -68.1). From this study, it is suggested that long-term DMPA use should not have any adverse effect on bone density even if it reduces serum estradiol.

PIP:

To assess the long-term effect of depot medroxyprogesterone acetate (DMPA) on bone mineral density, 50 current DMPA users with a minimum of 36 months (mean, 59.14 months) of continuous use recruited from a family planning clinic in Bangkok, Thailand, were compared with 50 current IUD users. Bone mineral density was measured by dual energy x-ray absorptiometry at the non-dominant distal and ultradistal forearm. Cases and controls were matched for age, income, weight, height, body mass index, and parity. Women with conditions known to affect bone density (e.g., smoking, alcohol consumption, metabolic bone disease) were excluded from both groups. The mean bone mineral density of distal forearm was 0.48 +or- 0.05 g/sq. cm in both groups, while the mean bone mineral density of ultradistal forearm was 0.38 +or- 0.06 g/sq. cm in DMPA users and 0.4 +or- 0.05 g/sq. cm in IUD users, a non-significant difference. However, serum estradiol levels measured within 5 days after cessation of menstruation were significantly reduced in DMPA users (52.67 +or- 25.1 pg/mL) compared to controls (147.51 +or- 91.9 pg/mL). These findings indicate that, even though DMPA induces estrogen deficiency, there seems to be no adverse effect on bone density.

PMID:
9306024
[Indexed for MEDLINE]
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