Depot medroxyprogesterone acetate and bone mineral density in adolescents--the Black Box Warning: a Position Paper of the Society for Adolescent Medicine.
The purpose of this Position Paper is to review the published Black Box Warning regarding depot medroxyprogesterone acetate (DMPA) and bone loss as it relates to adolescent girls. The scientific findings that prompted the Food and Drug Administration to issue the warning are reviewed and the following additional issues are considered: (1) likely low risk of fracture related to DMPA use, (2) evidence of at least partial recovery after discontinuation of the method, and (3) the need to balance the physical, social and economic cost of adolescent pregnancy versus the immediate and long-term impact of DMPA on bone. A list of clinical guidelines is included, the main recommendation of which is to continue prescription of DMPA, with counseling about the risks and benefits, in most of the adolescent population desiring to use this contraceptive method.
Cromer
Barbara A
BA
CASE School of Medicine, Cleveland, Ohio, USA.
Scholes
Delia
D
Berenson
Abbey
A
Cundy
Tim
T
Clark
M Kathleen
MK
Kaunitz
Andrew M
AM
D000293:Adolescent; D000295:Adolescent Medicine; D015519:Bone Density / Q000187:drug effects*; D001862:Bone Resorption / Q000139:chemically induced; D002136:Calcium, Dietary; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects*; D000075202:Contraindications; D003376:Counseling; D003692:Delayed-Action Preparations; D004348:Drug Labeling; D005260:Female; D050723:Fractures, Bone / Q000209:etiology; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000009:adverse effects*; D012955:Societies, Medical; D014481:United States; D014486:United States Food and Drug Administration
D002136:Calcium, Dietary; D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations; D017258:Medroxyprogesterone Acetate