title: Exploratory study of the effect of lifestyle counselling on bone mineral density and body composition in users of the contraceptive depot-medroxyprogesterone acetate.
abstract: OBJECTIVE
  To compare variations in bone mineral density (BMD) and body composition (BC) in depot-medroxyprogesterone acetate (DMPA) users and nonusers after providing counselling on healthy lifestyle habits.
  
  
  METHODS
  An exploratory study in which women aged 18 to 40 years participated: 29 new DMPA users and 25 new non-hormonal contraceptive users. All participants were advised on healthy lifestyle habits: sun exposure, walking and calcium intake. BMD and BC were assessed at baseline and 12 months later. Statistical analysis included the Mann-Whitney test or Student's t-test followed by multiple linear regression analysis.
  
  
  RESULTS
  Compared to the controls, DMPA users had lower BMD at vertebrae L1 and L4 after 12 months of use. They also had a mean increase of 2 kg in total fat mass and an increase of 2.2% in body fat compared to the non-hormonal contraceptive users. BMD loss at L1 was less pronounced in DMPA users with a calcium intake ≥ 1 g/day compared to DMPA users with a lower calcium intake.
  
  
  CONCLUSIONS
  DMPA use was apparently associated with lower BMD and an increase in fat mass at 12 months of use. Calcium intake ≥ 1 g/day attenuates BMD loss in DMPA users. Counselling on healthy lifestyle habits failed to achieve its aims.
authors.affiliation: Human Reproduction Unit, Department of Obstetrics and Gynaecology, School of Medical Sciences and the National Institute of Hormones and Women's Health, University of Campinas (UNICAMP) , Campinas, SP , Brazil.
authors.forename: Waleska
authors.initials: W
authors.lastname: Modesto
authors.forename: M Valeria
authors.initials: MV
authors.lastname: Bahamondes
authors.forename: Priscila
authors.initials: P
authors.lastname: Silva dos Santos
authors.forename: Arlete
authors.initials: A
authors.lastname: Fernandes
authors.forename: Natalia
authors.initials: N
authors.lastname: Dal'Ava
authors.forename: Luis
authors.initials: L
authors.lastname: Bahamondes
mesh_terms: D000293:Adolescent; D000328:Adult; D001823:Body Composition / Q000187:drug effects*; D015519:Bone Density / Q000187:drug effects*; D002136:Calcium, Dietary / Q000008:administration & dosage; D003271:Contraceptive Agents, Female / Q000009:adverse effects*; D003376:Counseling; D005260:Female; D006801:Humans; D008019:Life Style; D017258:Medroxyprogesterone Acetate / Q000009:adverse effects*; D009043:Motor Activity; D010024:Osteoporosis / Q000139:chemically induced; D013472:Sunlight; D015430:Weight Gain / Q000187:drug effects; D055815:Young Adult
chemical_list: D002136:Calcium, Dietary; D003271:Contraceptive Agents, Female; D017258:Medroxyprogesterone Acetate
keywords: Body composition; Bone mineral density; Depot-medroxyprogesterone acetate