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Depot medroxyprogesterone acetate use after peak bone mass is associated with increased bone turnover but no decrease
Jennifer S Walsh1, Richard Eastell, Nicola F Peel
1Academic Unit of Bone Metabolism, Northern General Hospital, Herries Road, Sheffield, S5 7AU, United Kingdom. jenniferwalsh@doctors.org.uk
Objective:
To ascertain whether increased bone turnover in depot medroxyprogesterone acetate (DMPA) users after peak bone mass is associated with bone mineral loss.
Design:
Three-year, observational, longitudinal study.
Setting:
General practice and family planning clinics.
Patient(S):
Women over age 34: established DMPA users (n = 23), discontinuers (n = 14), and controls (n = 27).
Main Outcome Measure(S):
Change in spine and hip bone mineral density (BMD).
Result(S):
Despite increased biochemical markers of bone turnover in DMPA users, there was no decrease in BMD. Bone turnover markers did not correlate with change in BMD.
Conclusion(S):
In established DMPA users, after peak bone mass, a single normal BMD measurement could provide reassurance for long-term use. Measurement of bone turnover does not predict bone loss in DMPA users.
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