Long-term depot-medroxyprogesterone acetate and bone mineral density.
The association between long-term use of depot-medroxyprogesterone acetate (DMPA) and bone mineral density (BMD) has been controversial, as seen in three case-control studies in New Zealand, Thailand, and the United Kingdom. In the present case-controlled study of BMD, a group of 67 Chinese women who had used DMPA from 5-15 years was compared with 218 women of the same age range who had not used any steroidal hormones. DMPA users were found to have a significantly lower BMD at lumbar vertebra (L2-4) (0.93 g/cm2), neck of femur (0.69 g/cm2), trochanter (0.59 g/cm2), and Ward's triangle (0.58 g/cm2), as compared with the control group, whose corresponding BMD values were 1.03 g/cm2, 0.83 g/cm2, 0.71 g/cm2, and 0.78 g/cm2, respectively (p < 0.001). The average percentage of bone loss per year was estimated to be 1.1% in L2-4, 2.3% in neck of femur, 2.4% in trochanter, and 3.5% in Ward's triangle. The percentage of bone loss in L2-4 was found to be more pronounced with age. This study provided information that the use of DMPA in a Chinese group for > 5 years in associated with bone loss, and a prospective study is needed to confirm these data, which are different from two case-control studies.
Tang
O S
OS
Department of Obstetrics & Gynaecology, University of Hong Kong, China.
Tang
G
G
Yip
P
P
Li
B
B
Fan
S
S
D015502:Absorptiometry, Photon; D000328:Adult; D000367:Age Factors; D000568:Amenorrhea; D015992:Body Mass Index; D015519:Bone Density / Q000187:drug effects*; D001862:Bone Resorption / Q000209:etiology*; D002118:Calcium / Q000378:metabolism; D016022:Case-Control Studies; D002681:China; D003271:Contraceptive Agents, Female / Q000494:pharmacology*; D005260:Female; D005269:Femur / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D017258:Medroxyprogesterone Acetate / Q000494:pharmacology*; D008875:Middle Aged; D012044:Regression Analysis; D011795:Surveys and Questionnaires
D003271:Contraceptive Agents, Female; D017258:Medroxyprogesterone Acetate; D002118:Calcium