Depot medroxyprogesterone acetate use after peak bone mass is associated with increased bone turnover but no decrease in bone mineral density
Received 3 September 2008; received in revised form 29 September 2008; accepted 3 October 2008. published online 14 November 2008.
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.
Academic Unit of Bone Metabolism, Northern General Hospital, Sheffield, United Kingdom
Reprint requests: Dr. Jennifer Walsh. Academic Unit of Bone Metabolism, Northern General Hospital, Herries Road, Sheffield, S5 7AU, United Kingdom (FAX: +44 114 2618775).
J.S.W. has nothing to disclose. R.E. has nothing to disclose. N.F.P. has nothing to disclose.
This work was supported by the Arthritis Research Campaign and the National Osteoporosis Society.
ABSTRACT