Bone loss in Depo-Provera users largely reversible.(Abstract)

2002 OCT 10 - (NewsRx.com & NewsRx.net) -- A new study confirms earlier reports that Depo-Provera, an injectable contraceptive popular among young and low-income American women, is strongly associated with bone density loss.

The study, funded by the U.S. National Institute of Child Health and Human Development (NICHD), also found that bone loss associated with Depo-Provera use appears to be largely reversible once the injections are stopped.

Bone density loss increases the risk for osteoporosis, a disease primarily of old age in which bones become fragile and are more likely to break. Women who use Depo-Provera are at risk for loss of bone density, although this study provides evidence that Depo-Provera's effects on bone density appear to be largely reversible. However, women with risk factors for osteoporosis (for example, smoking, thin or small frame, prior broken bones, Caucasian or Asian ancestry, family history of osteoporosis, diet low in calcium) should discuss the issue of bone loss with their health care providers when considering this form of contraception.

The study was published in the journal Epidemiology (2002;13(5):581-587).

"Contraceptive choice is a highly individual decision," said Duane Alexander, MD, director of the NICHD. "When women choose a contraceptive, they should carefully discuss with their physicians the risks and benefits of each method, and how those risks and benefits apply to their individual situations."

"Although the bone loss seen in this study is of concern, it is reassuring to see how quickly bone density increased after discontinuing Depo-Provera," said Steven C. Kaufman, MD, a medical officer with NICHD's Contraception and Reproductive Health Branch. "In addition to being aware of each side effect of whatever family planning method they choose, women should also consider how well that method protects against unintended pregnancy."

Some earlier studies found an association between Depo-Provera use and decreased bone density, while others did not. However, many previous studies of Depo-Provera use and bone density only measured subjects' bone densities at one point in time, rather than at several points over the course of an extended time period. Furthermore, only one previous study looked at the effects of discontinuing Depo-Provera use on bone density.