Researchers conducted this study to investigate depot medroxyprogesterone (DMPA)-associated bone loss in a general practice setting.
Participants were forty-eight patients from a single practice who had used DMPA for contraception for more than two years. All patients had serum oestradiol, and if the serum level was <52 pmol/l or >52 pmol/l with menopausal symptoms, BMD measurements were made at the LS and FN using DEXA. Thirty-two patients had bone densitometry, of whom 27 had serum oestradiol <52 pmol/l and five >52 pmol/l associated with menopausal symptoms. Of the remaining 16 patients, nine patients had serum oestradiol <52 pmol/l but did not have a BMD as they moved away or switched to another contraceptive.
BMD results showed a significantly reduced bone mass at both sites with a mean Z score LS -0.84 and FN -0.32. Eighteen women had either osteopenia or osteoporosis at the LS. There were trends to an association of a family history of height loss or tobacco smoking for LS and FN Z scores that did not quite achieve significance. There was also a trend to lower body weight in those with a possible family history of osteoporosis or smokers and an inverse correlation of weight with BMD at the FN. A non-significant inverse correlation at the LS.
The present results demonstrate that a low bone mass should be considered in patients with prolonged DMPA usage, especially if they have risk factors for osteoporosis.