Bone density recovery after depot medroxyprogesterone acetate injectable contraception use.
BACKGROUND
While depot medroxyprogesterone acetate (DMPA) is a highly effective contraceptive used by millions of women, its use is associated with bone mineral density (BMD) loss, raising concerns about long-term risk of osteoporosis and/or fractures.


METHODS
We conducted a systematic review of studies published in PubMed from 1996 to 2006, evaluating changes in BMD after discontinuation of DMPA. Ten primary clinical or observational studies were identified addressing this issue.


RESULTS
BMD consistently returned toward or to baseline values following DMPA discontinuation in women of all ages. This recovery in BMD was seen as early as 24 weeks after stopping therapy and persisted for as long as women were followed up; BMD in past DMPA users was similar to that in nonusers.


CONCLUSIONS
Bone loss occurring with DMPA use is reversible and is not likely to be an important risk factor for low bone density and fractures in older women, although data on fracture risk in DMPA users are lacking.
Kaunitz
Andrew M
AM
Department of Obstetrics and Gynecology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA. andrew.kaunitz@jax.ufl.edu
Arias
Raquel
R
McClung
Michael
M
D015519:Bone Density / Q000187:drug effects*; D001862:Bone Resorption / Q000453:epidemiology; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000009:adverse effects*; D017698:Postmenopause; D012307:Risk Factors; D013997:Time Factors
D003271:Contraceptive Agents, Female; D017258:Medroxyprogesterone Acetate