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Adolescent women who use the injectable contraceptive depot medroxyprogesterone acetate lose bone mineral density each year they are on the drug but appear to rapidly recover that loss when the drug is withdrawn, results of a prospective study suggest.
When counseling young women on birth control methods, physicians should consider DMPA's effect on bone mineral density (BMD).
"The potential loss of bone density is one consideration of the many that go into a women's choice of contraceptive method," said Delia Scholes, Ph.D., of the Center for Health Studies, Seattle, and her associates.
The researchers prospectively examined BMD in a cohort of 170 females aged 14-18. A total of 80 participants were using DMPA, and 90 were not. The DMPA-exposed teens were significantly more likely to be current smokers, to have been pregnant, have reached earlier menarche, and have a higher body mass index and body fat percentage (Arch. Pediatr. Adolesc. Med. 2005;159:139-44).
During the study, 61 of the DMP users discontinued the contraceptive, affording the opportunity to observe any subsequent changes in BMD.
The DMPA-exposed subjects were receiving the standard dose of 150 mg every 3 months. About 30% of them had received only 1 injection, 31% had received 2 or 3 injections, 21% had received 4-7 injections, and 18% had received at least 18 injections.
In the comparison group, 19% were using oral contraceptives at baseline.