Depo-Provera (depot medroxyprogesterone acetate) use after bariatric surgery

Area of Science:

• Reproductive Health
• Bariatric Surgery Outcomes
• Endocrinology

Background:

• Rising obesity rates in the US necessitate bariatric surgery, impacting reproductive-aged women.
• Obese women have unique medical considerations, especially post-bariatric surgery.
• Depot medroxyprogesterone acetate (DMPA) and bariatric surgery both affect bone density.

Purpose of the Study:

• To review the implications of DMPA use in obese women pre- and post-bariatric surgery.
• To clarify the combined effects of DMPA and bariatric surgery on bone loss and fracture risk.
• To assess DMPA's impact on weight management and venous thromboembolism (VTE) risk after bariatric procedures.

Main Methods:

• Literature review focusing on DMPA and bariatric surgery.
• Analysis of studies on bone density changes associated with DMPA and weight loss.
• Evaluation of VTE risk in the context of obesity, bariatric surgery, and DMPA use.

Main Results:

• The additive effect of DMPA and bariatric surgery on bone loss and fracture risk remains unclear.
• DMPA is associated with weight gain in adolescents, but not adult women, post-bariatric surgery.
• Concurrent DMPA use post-bariatric surgery is unlikely to increase VTE risk.

Conclusions:

• Clear guidelines are needed for counseling obese women of reproductive age after bariatric surgery regarding DMPA.
• Caution is advised when prescribing DMPA to adolescents post-bariatric surgery due to potential weight gain.
• Current evidence suggests DMPA use is safe concerning VTE risk in the post-bariatric surgery period.