Predictors of Higher Bone Mineral Density Loss and Use of Depot Medroxyprogesterone Acetate
Open accessAbstract
OBJECTIVE: To identify possible predictive factors of higher bone loss, defined as at least 5%, at the spine or femoral neck, over time in depot medroxyprogesterone acetate (DMPA) users. METHODS: Bone mineral density (BMD) was measured at the lumbar spine and femoral neck every 6 months in 240 white, African-American, and Hispanic women using DMPA. For the purpose of analysis, an arbitrary value of at least 5% BMD loss from the baseline value after 24 months of DMPA use at either the lumbar spine or the femoral neck was considered as higher BMD loss. Logistic regression analysis was then used to examine factors predictive of at least 5% BMD loss at either site. RESULTS: Of the initial 240 DMPA users, 95 completed 24 months of follow-up. Forty-five of the 95 DMPA users (47.4%) had at least 5% BMD loss at the lumbar spine or femoral neck by 24 months. Multivariable logistic regression model showed that at least 5% BMD loss was associated with current smoking (adjusted odds ratio [OR] 3.88, 95% confidence interval [CI] 1.26-11.96), calcium intake (in 100 mg) (OR 0.81, 95% CI 0.65-0.99), and parity (OR 0.49, 95% CI 0.29-0.82). Age, race or ethnicity, previous contraceptive use, and body mass index were not associated with higher BMD loss. CONCLUSION: The risk of higher BMD loss associated with DMPA use may be reduced by quitting smoking and increasing calcium intake. Having had a child is also protective. LEVEL OF EVIDENCE: II.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Long-term use of depot medroxyprogesterone acetate preparations impacts adversely on bone mineral density (BMD).
“Long-term use of depot medroxyprogesterone acetate preparations impacts adversely on bone mineral density (BMD) [9].”
From Reduced pelvic pain in women with endometriosis: efficacy of long-term dienogest treatment (2012) · cites this paper as [9]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Unintended Pregnancy in the United States
Henshaw, S. K. (1998) · Family Planning Perspectives · doi:10.2307/2991522 · Cited by 1,375 · see citing works
Use of Contraception and Use of Family Planning Services in the United States: 1982-2002
Mosher, W. D., Martinez, G. M., Chandra, A., Abma, J. C., & Willson, S. J. (2004) · PsycEXTRA Dataset · doi:10.1037/e609122007-001 · Cited by 556 · see citing works
Oral contraceptive discontinuation: A prospective evaluation of frequency and reasons
Rosenberg, M. J., & Waugh, M. S. (1998) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(98)70047-x · Cited by 437 · see citing works
Scholes, D., LaCroix, A. Z., Ichikawa, L. E., Barlow, W. E., & Ott, S. M. (2005) · Archives of Pediatrics & Adolescent Medicine · doi:10.1001/archpedi.159.2.139 · Cited by 221 · see citing works
Injectable Hormone Contraception and Bone Density: Results from a Prospective Study
Scholes, D., LaCroix, A. Z., Ichikawa, L. E., Barlow, W. E., & Ott, S. M. (2002) · Epidemiology · doi:10.1097/00001648-200209000-00015 · Cited by 187 · see citing works
Bone density recovery after depot medroxyprogesterone acetate injectable contraception use
Kaunitz, A. M., Arias, R., & McClung, M. R. (2008) · Contraception · doi:10.1016/j.contraception.2007.10.005 · Cited by 148 · see citing works
Bone mineral density changes over two years in first-time users of depot medroxyprogesterone acetate
Clark, M. K., Sowers, M. R., Nichols, S., & Levy, B. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.04.064 · Cited by 126 · see citing works
Effects of Hormonal Contraception on Bone Mineral Density After 24 Months of Use
Berenson, A. B., Breitkopf, C. R., Grady, J. J., Rickert, V. I., & Thomas, A. R. (2004) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000117082.49490.d5 · Cited by 118 · see citing works
Self-citationKaunitz, A. M., Miller, P. D., Rice, V. M., Ross, D., & McClung, M. R. (2006) · Contraception · doi:10.1016/j.contraception.2006.03.010 · Cited by 118 · see citing works
Maternity and bone mineral density
Karlsson, M. K., Ahlborg, H. G., & Karlsson, C. (2005) · Acta Orthopaedica · doi:10.1080/00016470510030274 · Cited by 118 · see citing works
Bone mineral density in adolescent females using depot medroxyprogesterone acetate
Lara-Torre, E., Edwards, C. P., Perlman, S., & Hertweck, S. P. (2004) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2003.11.017 · Cited by 117 · see citing works
Cromer, B. A., Bonny, A. E., Stager, M., Lazebnik, R., Rome, E. S., Ziegler, J., Camlin-Shingler, K., & Secic, M. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.10.070 · Cited by 116 · see citing works
Clark, M. K., Sowers, M. R., Levy, B. T., & Nichols, S. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.05.024 · Cited by 111 · see citing works
Bone mineral density in grand multiparous women with extended lactation
Henderson, P. H., Sowers, M. R., Kutzko, K., & Jannausch, M. L. (2000) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2000.107468 · Cited by 100 · see citing works
Cromer, B. A., Lazebnik, R., Rome, E. S., Stager, M., Bonny, A. E., Ziegler, J., & Debanne, S. M. (2005) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2004.07.041 · Cited by 86 · see citing works
Cundy, T., Ames, R. W., Horne, A. M., Clearwater, J. M., Roberts, H., Gamble, G. D., & Reid, I. R. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2002-020874 · Cited by 82 · see citing works
Berenson, A. B., Rahman, M., Breitkopf, C. R., & Bi, L. X. (2008) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e3181875b78 · Cited by 76 · see citing works
Self-citationHigh parity is associated with increased bone size and strength
SPECKER, B. L., & Binkley, T. L. (2005) · Osteoporosis International · doi:10.1007/s00198-005-1978-1 · Cited by 65 · see citing works
Berenson, A. B., Odom, S. D., Breitkopf, C. R., & Rahman, M. (2008) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2008.04.048 · Cited by 64 · see citing works
Self-citationA dietary calcium rapid assessment method (RAM)
Hertzler, A. A., & Frary, R. B. (1994) · Topics in Clinical Nutrition · doi:10.1097/00008486-199406000-00013 · Cited by 59 · see citing works
Murphy, P. A., & Brixner, D. I. (2008) · Contraception · doi:10.1016/j.contraception.2008.01.002 · Cited by 53 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [14]Hosmer DW Jr Lemeshow S Applied Logistic Regression 2000 Second Edition New York John Wiley & Sons, Inc
Cited by
Sorted by citations
Reduced pelvic pain in women with endometriosis: efficacy of long-term dienogest treatment
Petraglia, F., Hornung, D., Seitz, C., Faustmann, T., Gerlinger, C., Luisi, S., Lazzeri, L., & Strowitzki, T. (2012) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-011-1941-7 · Cited by 200 · see citing works
Ebert, A. D., Dong, L., Merz, M., Kirsch, B., Francuski, M., Böttcher, B., Roman, H., Suvitie, P., Hlavackova, O., Gude, K., et al. (2017) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2017.01.014 · Cited by 97 · see citing works
Sexuality and Disability in Adolescents
Holland-Hall, C. M., & Quint, E. H. (2017) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2016.11.011 · Cited by 74 · see citing works
Schuiling, K., Robinia, K., & Nye, R. (2011) · Journal of Midwifery & Women s Health · doi:10.1111/j.1542-2011.2011.00135.x · Cited by 61 · see citing works
Prescribing Contraceptives for Women with Schizophrenia
Seeman, M. V., & ROSS, R. W. (2011) · Journal of Psychiatric Practice · doi:10.1097/01.pra.0000400263.52913.dc · Cited by 58 · see citing works
Canadian Contraception Consensus (Part 3 of 4): Chapter 8 – Progestin-Only Contraception
Black, A., Guilbert, É., Costescu, D., Dunn, S., Fisher, W. A., Kives, S. L., Mirosh, M., Norman, W. V., Pymar, H. C., Reid, R. L., et al. (2016) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2015.12.003 · Cited by 32 · see citing works
Gonadotrophin-releasing hormone analogues and endometriosis: current strategies and new insights
Hashim, H. A. (2012) · Gynecological Endocrinology · doi:10.3109/09513590.2011.650751 · Cited by 29 · see citing works
Counselling Patients with Uterine Fibroids: A Review of the Management and Complications
Simms‐Stewart, D., & Fletcher, H. M. (2012) · Obstetrics and Gynecology International · doi:10.1155/2012/539365 · Cited by 23 · see citing works
Factors associated with bone mineral density in healthy African women
for the MTN-003B Protocol Team, Mgodi, N. M., Kelly, C., Gati, B. M., Greenspan, S. L., Dai, J. Y., Bragg, V., Livant, E., Piper, J. M., Nakabiito, C., et al. (2015) · Archives of Osteoporosis · doi:10.1007/s11657-015-0206-7 · Cited by 21 · see citing works
Viola, A. S., Castro, S., Marchi, N. M., Bahamondes, M. V., Viola, C. F. M., & Bahamondes, L. G. (2010) · Contraception · doi:10.1016/j.contraception.2010.11.007 · Cited by 19 · see citing works
Assessment of bone health in children with disabilities
Kecskemethy, H. H., & Harcke, H. T. (2014) · Journal of Pediatric Rehabilitation Medicine · doi:10.3233/prm-140280 · Cited by 12 · see citing works
Quintino‐Moro, A., Zantut‐Wittmann, D. E., dos Santos, P. D. N. S., Silva, C. A., Bahamondes, L. G., & Fernandes, A. M. D. S. (2019) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.12958 · Cited by 9 · see citing works
Segall‐Gutierrez, P., Agarwal, R., Ge, M. X., Lopez, C. M., Hernandez, G. D., & Stanczyk, F. Z. (2013) · The European Journal of Contraception & Reproductive Health Care · doi:10.3109/13625187.2013.774358 · Cited by 8 · see citing works
Contraceptive Selection for the Endocrine Patient: What an Endocrinologist Should Know
Zaman, A., Lazorwitz, A. M., & Wierman, M. E. (2025) · Endocrine Reviews · doi:10.1210/endrev/bnaf016 · Cited by 7 · see citing works
Kiweewa, F. M., Stranix‐Chibanda, L., Yende‐Zuma, N., Dadabhai, S. S., Owor, M., Hanley, S., Nyati, M., Chinula, L., Pettifor, J. M., Brummel, S. S., et al. (2025) · AIDS · doi:10.1097/qad.0000000000004148 · Cited by 5 · see citing works
DMPA: battered and bruised but still needed and used in the USA
Nelson, A. L. (2010) · Expert Review of Obstetrics & Gynecology · doi:10.1586/eog.10.60 · Cited by 5 · see citing works
Black, A., Guilbert, É., Costescu, D., Dunn, S., Fisher, W. A., Kives, S. L., Mirosh, M., Norman, W. V., Pymar, H. C., Reid, R. L., et al. (2016) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2016.03.005 · Cited by 4 · see citing works
Complications of Uterine Fibroids and Their Management
Fletcher, H. M., Burrell, C., Bassaw, B., & Thomas, E. O. (2012) · Obstetrics and Gynecology International · doi:10.1155/2012/932436 · Cited by 2 · see citing works
Managing Bone Fragility in the Child with Cerebral Palsy
Kecskemethy, H. H., & Bachrach, S. (2020) · Springer eBooks · doi:10.1007/978-3-319-74558-9_26 · Cited by 2 · see citing works
Rabe, T., Ludwig, M. Z., Merkle, E., Hj, A., Kj, B., Hadji, P., Ao, M., Merki, G., Egarter, C., König, K., et al. (2013) · Journal für Reproduktionsmedizin und Endokrinologie · Cited by 1 · see citing works
Vallim, J. H. (2019) · doi:10.47749/t/unicamp.2019.1096821 · Cited by 1 · see citing works
Managing Bone Fragility in the Child with Cerebral Palsy
Kecskemethy, H. H., & Bachrach, S. (2018) · Springer eBooks · doi:10.1007/978-3-319-50592-3_26-1
- Authors
- Rahman, M., & Berenson, A. B.
- Affiliations
- National Institutes of Health (US)
- Venue
- Obstetrics & Gynecology
- Published
- 2010-01
- Volume
- 115
- Issue
- 1
- Pages
- 35-40
- ISSN
- 0029-7844 (ISSN-L)
- PMC
- PMC2811404
- OpenAlex
- W2011907767
- Cited by
- 22
- References
- 21
- Citations by year
- 2025: 2 · 2020: 1 · 2019: 2 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 1 · 2014: 1 · 2013: 2 · 2012: 3
- FWCI
- 2.81
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD039883, K24HD043659, R01HD39883)
- 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 › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- depot medroxyprogesterone acetate, bone mineral loss, osteoporosis risk factors, smoking, calcium intake, parity, lumbar spine, femoral neck, oral contraceptives, women
- MeSH terms
- Adult, Calcium, Dietary, Contraceptive Agents, Female, Delayed-Action Preparations, Female, Femur Neck, Humans, Lumbar Vertebrae, Parity, Pregnancy, Smoking, Bone Density, Logistic Models, Medroxyprogesterone Acetate
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
