title: Double-blinded randomized controlled trial of estrogen supplementation in adolescent girls who receive depot medroxyprogesterone acetate for contraception.
abstract: 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.
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, Ohio, USA. bcromer@metrohealth.org
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Cromer
authors.forename: Rina
authors.initials: R
authors.lastname: Lazebnik
authors.forename: Ellen
authors.initials: E
authors.lastname: Rome
authors.forename: Margaret
authors.initials: M
authors.lastname: Stager
authors.forename: Andrea
authors.initials: A
authors.lastname: Bonny
authors.forename: Julie
authors.initials: J
authors.lastname: Ziegler
authors.forename: Sara M
authors.initials: SM
authors.lastname: Debanne
mesh_terms: 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
chemical_list: D003271:Contraceptive Agents, Female; D004958:Estradiol; D017258:Medroxyprogesterone Acetate