Double-blinded randomized controlled trial of estrogen supplementation in adolescent girls who receive depot medroxyprogesterone acetate for contraception.
OBJECTIVE
The purpose of this clinical trial was to evaluate the effect of estrogen supplementation on bone mineral density in adolescent girls who received depot medroxyprogesterone acetate for contraception.


METHODS
One hundred twenty-three adolescents who began receiving depot medroxyprogesterone acetate injections every 12 weeks were assigned randomly to receive monthly injections of estradiol cypionate or placebo. The main outcome was bone mineral density that was measured by dual energy x-ray absorptiometry for 12 (n = 69) to 24 (n = 36) months. Participants, technicians, and physicians were blinded to estrogen treatment.


RESULTS
Over the 24-month period, the percentage of change from baseline bone mineral density at the lumbar spine was 2.8% in the estradiol cypionate group versus -1.8% in the placebo group ( P <.001). At the femoral neck, the percentage of change from baseline bone mineral density was 4.7% in the estradiol cypionate group versus -5.1% in the placebo group ( P <.001).


CONCLUSIONS
Our results suggest that estrogen supplementation is protective of bone in adolescent girls who receive depot medroxyprogesterone acetate injections.
Cromer
Barbara A
BA
Case Western Reserve University School of Medicine, Cleveland, Ohio, USA. bcromer@metrohealth.org
Lazebnik
Rina
R
Rome
Ellen
E
Stager
Margaret
M
Bonny
Andrea
A
Ziegler
Julie
J
Debanne
Sara M
SM
D015502:Absorptiometry, Photon; D000293:Adolescent; D015519:Bone Density / Q000187:drug effects*; D003271:Contraceptive Agents, Female; D004311:Double-Blind Method; D004958:Estradiol / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D005269:Femur; D006801:Humans; D007273:Injections, Intramuscular; D008159:Lumbar Vertebrae; D017258:Medroxyprogesterone Acetate; D016896:Treatment Outcome
D003271:Contraceptive Agents, Female; D004958:Estradiol; D017258:Medroxyprogesterone Acetate