Bone Mineral Density, Fracture, and Vitamin D in Adolescents and Young Women Using Depot Medroxyprogesterone Acetate

Pitts, Sarah; Feldman, Henry A.; Dorale, Amanda; Gordon, Catherine M.

doi:10.1016/j.jpag.2011.07.014

Cited by 23 publications

(10 citation statements)

References 16 publications

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“…Lunelle® or Cyclofem, a combined injectable which consists of 25 mg MPA and 5 mg estradiol cypionate is no longer available in the United States but is widely used in Latin America and some parts of Asia. Injectable contraceptives of DMPA (without estrogen) have been associated with a potential lowering in bone mineral density when used at the time of peak bone mass building in young women [68]. Concern about bone loss, especially in adolescents, led to recommendations that DMPA be used in a lower dose form and for only 2 years in young women, although there have been no reports of increased fracture incidence in DMPA users [68].…”

Section: Female Contraceptionmentioning

confidence: 99%

Contraception technology: past, present and future

2013

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Steady progress in contraception research has been achieved over the past 50 years. Hormonal and non-hormonal modern contraceptives have improved women’s lives by reducing different health conditions that contributed to considerable morbidity. However the contraceptives available today are not suitable to all users and the need to expand contraceptive choices still exists. Novel products such as new implants, contraceptive vaginal rings, transdermal patches and newer combinations of oral contraceptives have recently been introduced in family planning programs and hormonal contraception is widely used for spacing and limiting births. Concerns over the adverse effects of hormonal contraceptives have led to research and development of new combinations with improved metabolic profile. Recent developments include use of natural compounds such as estradiol (E2) and estradiol valerate (E2V) with the hope to decrease thrombotic risk, in combination with newer progestins derived from the progesterone structure or from spirolactone, in order to avoid the androgenic effects. Progesterone antagonists and progesterone receptor modulators are highly effective in blocking ovulation and preventing follicular rupture and are undergoing investigations in the form of oral pills and in semi long-acting delivery systems. Future developments also include the combination of a contraceptive with an antiretroviral agent for dual contraception and protection against sexually transmitted diseases, to be used before intercourse or on demand, as well as for continuous use in dual-protection rings. Alhough clinical trials of male contraception have reflected promising results, limited involvement of industry in that area of research has decreased the likelihood of having a male method available in the current decade. Development of non-hormonal methods are still at an early stage of research, with the identification of specific targets within the reproductive system in ovaries and testes, as well as interactions between spermatozoa and ova. It is hoped that the introduction of new methods with additional health benefits would help women and couples with unmet needs to obtain access to a wider range of contraceptives with improved acceptability.

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Section: Female Contraceptionmentioning

confidence: 99%

Contraception technology: past, present and future

2013

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“…The biggest concern about this medication is the loss of bone mineral density and risk of fracture. However, this effect is transient and bone mineral density increases again upon discontinuation of the medication and routine follow-up of bone mineral density is not recommended in these patients, but adequate intake of calcium and vitamin D should be encouraged (21). Developmentally delayed adolescents are already predisposed to poor bone health, due to anticonvulsant medication use, reduced mobility, and undernourishment.…”

Section: Depot Medroxyprogesterone Acetate (Dmpa)mentioning

confidence: 99%

Management of Menstrual and Gynecologic Concerns in Girls with Special Needs

Dural¹,

Tas²,

Akhan³

2020

Jcrpe

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For girls with physical and developmental disabilities and their families/caregivers, puberty and menstruation can present significant problems such as vulnerability, abuse risk, unintended pregnancies, difficulties with managing menstrual hygiene, abnormal uterine bleeding, dysmenorrhea, behavioral difficulties/mood concerns or changes in seizure pattern. Healthcare providers may have an important and positive impact for both the adolescents and their families/caregivers during this stage of life. Whether menstrual manipulation is indicated should be decided after a detailed history is taken from both the patient and the caregivers to determine the impact of current problems on quality of life. It should be explained that complete amenorrhea is difficult to achieve and realistic expectations should be addressed. The goals for the management of menstrual concerns should be a reduction in the amount and total days of menstrual flow, reduction of menstrual pain and suppression of ovulatory or cyclic symptoms, depending on each individual patient's needs. Advantages and disadvantages of available treatment methods should also be discussed. Abstract 41 J Clin Res Pediatr Endocrinol 2020;12(Suppl 1):41-45

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“…Bone density DMPA is a commonly used method for menstrual suppression, due to its convenience of intramuscular injections every 3 months and high rate of amenorrhea, but has been shown to cause bone loss during adolescence, instead of the expected bone gain during this time. 32 measurements are complicated to use in young women with disabilities, due to limited available comparison data, as well as difficulty positioning due to issues like scoliosis. 33 Several studies have looked at BMD and fracture risks in teens with disabilities.…”

Section: The Use Of Depo Medroxy Progesterone Acetate ( Dmpa) In Tmentioning

confidence: 99%

Adolescents with Special Needs: Clinical Challenges in Reproductive Health Care

Quint

2016

Journal of Pediatric and Adolescent Gynecology

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Bone Mineral Density, Fracture, and Vitamin D in Adolescents and Young Women Using Depot Medroxyprogesterone Acetate

Cited by 23 publications

References 16 publications

Contraception technology: past, present and future

Contraception technology: past, present and future

Management of Menstrual and Gynecologic Concerns in Girls with Special Needs

Adolescents with Special Needs: Clinical Challenges in Reproductive Health Care

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