Menopausal bone loss in long-term users of depot medroxyprogesterone acetate contraception

Cundy, Tim; Cornish, Jillian; Roberts, Helen; Reid, Ian R.

doi:10.1067/mob.2002.122420

Cited by 55 publications

(21 citation statements)

References 15 publications

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“…A longitudinal study that was carried out to evaluate BMD recovery in postmenopausal women who were DMPA users during their reproductive years reported no significant differences in BMD between former DMPA users and nonusers at lumbar spine, femoral neck, Ward's triangle, trochanter and total body [67]. Moreover, no correlation was found with duration of use, age at initiation of contraceptive use, age at discontinuation or time between discontinuation and menopause.…”

Section: Depot-medroxyprogesterone Acetatementioning

confidence: 81%

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Does the use of hormonal contraceptives affect bone mineral density?

Bahamondes

2007

Expert Review of Obstetrics & Gynecology

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There is concern regarding the influence of hormonal contraceptives on bone mineral density (BMD), especially following the alert issued by the US FDA regarding the use of depot-medroxyprogesterone acetate (DMPA). That statement raised the concern, not only for health providers but also for users and potential users, that other combined contraceptives and progestin-only (p-only) contraceptives could have a deleterious effect on BMD. Overall, hormonal and nonhormonal contraceptives are known to have a high impact on the lives and health of women, as well as on public health. The benefits greatly surpass any risks, including the risk of any potential effect on BMD. Although convincing evidence is accumulating that DMPA may cause loss of BMD, most studies evaluating the effects of combined and other p-only contraceptives on BMD have failed to find a strong effect. Some have reported a beneficial effect. However, hormonal contraceptives were not designed to protect bone health and further studies are necessary.

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Section: Depot-medroxyprogesterone Acetatementioning

confidence: 81%

“…In addition, it can be argued that the rapid loss occurring after the menopause [68] occurs in DMPA users at a younger age. Nevertheless, the recovery of BMD after the menopause is greater in former users than nonusers [67].…”

Section: Depot-medroxyprogesterone Acetatementioning

confidence: 99%

Does the use of hormonal contraceptives affect bone mineral density?

Bahamondes

2007

Expert Review of Obstetrics & Gynecology

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“…However, if BMD returns to normal after discontinuation of DMPA some time before menopause, there should be no subsequent increase in fracture risk. Cundy, Scholes and others demonstrated some recovery of BMD in women who discontinued DMPA 9,16 , and Cundy has shown an amelioration of the speed of post-menopausal bone loss in a prospective study 17 , suggesting that the effect is transient, but the data are limited and it is possible that recovery of BMD is not complete, especially if the discontinuation of DMPA is close to the expected age of menopause.…”

Section: Discussionmentioning

confidence: 96%

Effect of depot medroxyprogesterone acetate on bone density in a Scottish industrial city

McGough¹,

Bigrigg²

2007

The European Journal of Contraception & Reproductive Health

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“…Cundy et al enrolled subjects aged 45-53 who had used DMPA continuously for at least 5 years and used DMPA up until menopause and a comparison group of women aged 47-55 who had not used hormonal contraception and who had experienced spontaneous menopause [48]. Although the comparison group experienced rapid bone loss in early menopause, with 6% loss from bone spine and hip at 3 years follow-up, DMPA users who did not take hormone therapy (HT) showed little change in BMD at both sites over the 3 years.…”

Section: Injectable Contraception (Dmpa): Skeletal Impact In Adult Prmentioning

confidence: 99%

“…DMPA users who subsequently used HT had significant increase in BMD at the spine and stable BMD at the hip. The authors postulated that the stability in BMD at menopause in DMPA users was due to the fact that DMPA users had, prior to menopause, already undergone bone loss due to hypoestrogenism and therefore did not lose any additional bone mass due to the hypoestrogenic state of menopause [48].…”

Section: Injectable Contraception (Dmpa): Skeletal Impact In Adult Prmentioning

confidence: 99%

Update on hormonal contraception and bone density

Isley

Kaunitz

2011

Rev Endocr Metab Disord

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Combination hormonal contraception and progestin-only contraception (including depot medroxyprogesterone acetate [DMPA]) are effective and convenient forms of reversible contraception that millions of women use worldwide. In recent years, observations of reduced bone mineral density in current users of these methods have led to concerns that this hormone-induced bone loss might translate into long-term increased fracture risk. Special focus has been placed on adolescent users who have not yet attained their peak bone mass as well as perimenopausal users. In 2004, the FDA added a black box warning to DMPA package labeling warning of the risk of significant bone loss and cautioning against long-term use (> 2 years). This article reviews evidence on the use of hormonal contraception and its effect on bone density in adolescent, premenopausal, and perimenopausal populations. Recommendations from reproductive healthcare organizations are reviewed and clinical recommendations are provided.

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Menopausal bone loss in long-term users of depot medroxyprogesterone acetate contraception

Cited by 55 publications

References 15 publications

Does the use of hormonal contraceptives affect bone mineral density?

Does the use of hormonal contraceptives affect bone mineral density?

Effect of depot medroxyprogesterone acetate on bone density in a Scottish industrial city

Update on hormonal contraception and bone density

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