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Study Identifies Women at Higher Risk of Significant Bone Loss From Injectable Birth Control GALVESTON, Tex -- December 22, 2009 -- Nearly half of women using depot medroxyprogesterone acetate (DMPA) will experience high bone mineral density (BMD) loss in the hip or lower spine within 2 years of beginning the contraceptive, according to a study published in the January 2010 issue of the journal Obstetrics and Gynecology. The study was the first to show that women on DMPA who smoke, have low levels of calcium intake, and never gave birth are at the highest risk for BMD loss. The researchers also found that high-risk women continued to experience significant losses in BMD during the third year of DMPA use, especially in the hip. “Bone mineral density loss is not a significant concern for all women who choose DMPA,” said senior author Abbey Berenson, MD, Department of Obstetrics And Gynecology, University of Texas Medical Branch, Galveston, Texas. According to Dr. Berenson, over the last several years there’s been a fair amount of confusion about how to counsel patients. “Based on these findings, clinicians have the information they need to recommend basic behaviour changes for high risk women to minimise BMD loss,” she said. The study followed 95 DMPA users for 2 years. In that time, 45 women had at least 5% BMD loss in the lower back or hip. A total of 50 women had less than 5% bone loss at both sites during the same period. By and large, BMD loss was higher in women who were current smokers, had never given birth, and had a daily calcium intake of 600 mg or less -- far below the recommended amounts. Moreover, BMD loss substantially increased among the women with all 3 risk factors. Age, race or ethnicity, previous contraceptive use, and body mass index were not associated with higher BMD loss. The researchers followed 27 of the women for an additional year and found that those who experienced significant BMD loss in the first 2 years continued to lose bone mass. “These losses, especially among women using DMPA for many years, are likely to take an extended period of time to reverse,” said first author Mahburbur Rahman, Center for Interdisciplinary Research in Women’s Health, Galveston, Texas. The researchers noted that while this study will help physicians counsel women with modifiable risk factors who wish to use DMPA, prevention of bone loss while using the contraceptive and reversibility of BMD loss are still not well understood and further research is needed. SOURCE: University of Texas Medical Branch E-mail this page to a friend or colleague! To print, use this version