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Progestin-only contraception prevents bone loss in postpartum breastfeeding women
Maria Laura Costa1, Jose Guilherme Cecatti, Fabiana G Krupa
1Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, PO Box 6030, 13083-881 Campinas, Sao Paulo, Brazil.
Background:
There are an increase in bone loss during the first 6 months postpartum and a complete recovery postweaning. A few studies of steroid contraceptive use during this period provide some evidence towards protection of bone loss with progestin-only contraceptive methods.
Objective:
The study was conducted to evaluate forearm bone mineral density (BMD) of breastfeeding postpartum women using nonhormonal and progestin-only contraceptive methods.
Study Design:
A prospective cohort study of postpartum women had an analysis performed at 6 months postpartum correlating BMD with contraceptive use. Forearm BMD was measured 7-10 days, 3 months and 6 months postpartum. Eighty-two women were analyzed, comparing nonhormonal (54) and progestin-only (28) contraceptive methods. Information about breastfeeding duration, amenorrhea and body mass index was collected.
Results:
Baseline characteristics of the study population showed no statistical differences between the groups. The median duration of breastfeeding for both groups was 183 days. A significant BMD decrease was observed for the nonhormonal group (p<.001); however, no statistical difference was detected for the progestin-only group. Body mass index, BMD at 7-10 days postpartum and total duration of breastfeeding were positively correlated with BMD at 6 months.
Conclusions:
Our findings suggest a preventive effect towards postpartum bone loss with progestin-only contraception in breastfeeding women.
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