Recovery of bone mineral density in adolescents following the use of depot medroxyprogesterone acetate contraceptive injections

Zeev Harel, Christine Cole Johnson, Melanie A. Gold, Barbara Cromer, Edward Peterson, Ronald Burkman, Margaret Stager, Robert Brown, Ann Bruner, Susan Coupey, Paige Hertweck, Henry Bone, Kevin Wolter, Anita Nelson, Sharon Marshall, Laura K. Bachrach

Research output: Contribution to journalArticlepeer-review

74 Scopus citations

Abstract

Background: Depot medroxyprogesterone acetate (DMPA) is a highly effective progestin-only contraceptive that is widely used by adolescents. We investigated bone mineral density (BMD) changes in female adolescents during and following use of this method. Study Design: A multicenter, prospective, non-randomized observational study in 98 healthy female adolescents aged 12-18 years who initiated DMPA intramuscular injections for contraception and provided BMD data for up to 240 weeks while receiving DMPA and for up to 300 weeks after DMPA cessation. BMD at the lumbar spine (LS), total hip (TH) and femoral neck (FN) was assessed by dual-energy X-ray absorptiometry. A mixed model analysis of variance was used to examine BMD changes. Results: At the time of their final DMPA injection, participants had mean BMD declines from baseline of 2.7% (LS), 4.1% (TH) and 3.9% (FN) (p<.001 at all three sites). Within 60 weeks of discontinuation of DMPA, mean LS BMD had returned to baseline levels, and 240 weeks after DMPA discontinuation, the mean LS BMD was 4.7% above baseline. Mean TH and FN BMD values recovered to baseline values more slowly: 240 weeks and 180 weeks, respectively, after the last DMPA injection. Conclusions: BMD loss in female adolescents receiving DMPA for contraception is substantially or fully reversible in most girls following discontinuation of DMPA, with faster recovery at the LS than at the hip.

Original languageEnglish (US)
Pages (from-to)281-291
Number of pages11
JournalContraception
Volume81
Issue number4
DOIs
StatePublished - Apr 1 2010
Externally publishedYes

Keywords

  • Adolescents
  • Bone density
  • Contraceptive agents
  • Depot medroxyprogesterone acetate

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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