Bone mineral density in adolescent and young adult women on injectable or oral contraception
Abstract
PURPOSE OF REVIEW: This report critically reviews recent original research articles that pertain to bone mineral density in young adult women utilizing injectable depot medroxyprogesterone acetate or oral contraceptives. RECENT FINDINGS: Some evidence indicates that depot medroxyprogesterone acetate and ultra-low dose oral contraceptives (containing 20 microg ethinyl estradiol) may interfere with the large increases normally observed in adolescence; however, the same degree of bone loss (or lack of bone gain) associated with these drugs is not so impressive in young adult women who would typically be experiencing small changes in bone mass. Data obtained from young adult women show that low dose (30-40 microg ethinyl estradiol) oral contraceptives seem to be more protective of bone than ultra-low dose oral contraceptives. The few extant data suggest that there may be substantial increases in bone mass after discontinuation of depot medroxyprogesterone acetate; no information is available regarding the response of bone after discontinuation of oral contraceptives. As the clinical risk for fracture is usually several decades later, several exogenous factors such as diet and exercise may exert overriding influences on later bone health. Moreover, without contraception, the clinical outcome may be unwanted pregnancy and its potential impact on bone health. SUMMARY: Recent findings suggest that depot medroxyprogesterone acetate and ultra-low dose oral contraceptives may interfere with achieving optimal peak bone mass in very young women; however, there may be substantial recovery after cessation of these methods and overriding long-term influences on bone health imposed by a myriad of lifestyle factors.
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Prolonged DMPA use is associated with decrease in BMD and increased risk of fracture due to estrogen deficiency.
“One of major sources of concerns regarding prolonged use of DMPA is the decrease of BMD and the increase risk of fracture, due to estrogen deficiency accompanying its use.”
From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [57]
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Liu, S. L., & Lebrun, C. M. (2006) · British Journal of Sports Medicine · doi:10.1136/bjsm.2005.020065 · Cited by 150 · see citing works
Oral and depot progestin therapy for endometriosis: towards a personalized medicine
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- Authors
- Cromer, B. A.
- Affiliations
- MetroHealth (US)
- Corresponding author
- Cromer, Barbara A.
- Venue
- Current Opinion in Obstetrics and Gynecology
- Published
- 2003-10
- Volume
- 15
- Issue
- 5
- Pages
- 353-357
- ISSN
- 1040-872X (ISSN-L)
- OpenAlex
- W2000796684
- Cited by
- 61
- References
- 20
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 5 · 2020: 2 · 2019: 1 · 2017: 1 · 2016: 3 · 2014: 1 · 2013: 4 · 2012: 3
- FWCI
- 6.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Obstetrics & Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer Pharmaceuticals
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD39009-1, R01HD039009)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Keywords
- bone mineral density, depot medroxyprogesterone acetate, oral contraceptives, peak bone mass, bone loss, young adult women, adolescent women, fracture risk, lifestyle factors
- MeSH terms
- Adolescent, Adult, Clinical Trials as Topic, Contraceptives, Oral, Contraceptives, Oral, Hormonal, Ethinyl Estradiol, Female, Humans, Osteoporosis, Bone Density, Medroxyprogesterone Acetate
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