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Related Experiment Videos

Progestogen-only contraception and bone mineral density: a systematic review.

Kathryn M Curtis1, Summer L Martins

  • 1Division of Reproductive Health, WHO Collaborating Center in Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. kmc6@cdc.gov

Contraception
|April 22, 2006
PubMed
Summary

Progestogen-only contraceptives, particularly depot medroxyprogesterone acetate (DMPA), may impact bone mineral density (BMD). Bone density loss associated with DMPA use was observed, but BMD improved after discontinuation.

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Area of Science:

  • Reproductive Health
  • Endocrinology
  • Bone Metabolism

Background:

  • Concerns exist regarding progestogen-only contraceptive effects on bone health.
  • Young women and perimenopausal women are key demographics of interest due to bone mass development and potential loss.

Purpose of the Study:

  • To systematically review the association between progestogen-only contraceptive use and fracture risk or bone mineral density (BMD).

Main Methods:

  • Systematic review of 39 articles from MEDLINE and EMBASE databases.
  • Evaluation of studies examining fracture risk and bone mineral density (BMD) in relation to progestogen-only contraceptive use.

Main Results:

  • Depot medroxyprogesterone acetate (DMPA) use was linked to a non-significant increase in stress fractures.

Related Experiment Videos

  • Cross-sectional studies showed lower mean BMD in DMPA users compared to nonusers (within 1 SD).
  • Longitudinal studies indicated greater BMD decrease over time with DMPA use, with recovery upon discontinuation. Limited data suggested other progestogen-only contraceptives did not affect BMD.

    • Conclusions:

    • DMPA use may be associated with a decrease in bone mineral density (BMD), though BMD appears to recover after cessation.
    • Evidence for other progestogen-only contraceptives impacting BMD is limited.