Progestin-only contraception prevents bone loss in postpartum breastfeeding women.
BACKGROUND
There are an increase in bone loss during the first 6 months postpartum and a complete recovery postweaning. A few studies of steroid contraceptive use during this period provide some evidence towards protection of bone loss with progestin-only contraceptive methods.


OBJECTIVE
The study was conducted to evaluate forearm bone mineral density (BMD) of breastfeeding postpartum women using nonhormonal and progestin-only contraceptive methods.


METHODS
A prospective cohort study of postpartum women had an analysis performed at 6 months postpartum correlating BMD with contraceptive use. Forearm BMD was measured 7-10 days, 3 months and 6 months postpartum. Eighty-two women were analyzed, comparing nonhormonal (54) and progestin-only (28) contraceptive methods. Information about breastfeeding duration, amenorrhea and body mass index was collected.


RESULTS
Baseline characteristics of the study population showed no statistical differences between the groups. The median duration of breastfeeding for both groups was 183 days. A significant BMD decrease was observed for the nonhormonal group (p<.001); however, no statistical difference was detected for the progestin-only group. Body mass index, BMD at 7-10 days postpartum and total duration of breastfeeding were positively correlated with BMD at 6 months.


CONCLUSIONS
Our findings suggest a preventive effect towards postpartum bone loss with progestin-only contraception in breastfeeding women.
Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, PO Box 6030, 13083-881 Campinas, Sao Paulo, Brazil.
Maria Laura
ML
Costa
Jose Guilherme
JG
Cecatti
Fabiana G
FG
Krupa
Patricia Moretti
PM
Rehder
Maria Helena
MH
Sousa
Lucia
L
Costa-Paiva
D000293:Adolescent; D000328:Adult; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D001942:Breast Feeding; D003267:Contraception / Q000379:methods; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007774:Lactation / Q000378:metabolism*; D049590:Postpartum Period; D011372:Progestins / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies
D003278:Contraceptives, Oral, Hormonal; D011372:Progestins