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  • Title: Effects of levonorgestrel-releasing subdermal contraceptive implants on bone density and bone metabolism.
    Author: Di X, Li Y, Zhang C, Jiang J, Gu S.
    Journal: Contraception; 1999 Sep; 60(3):161-6. PubMed ID: 10640160.
    Abstract:
    A prospective, randomized clinical trial observed the effects of Norplant long-term contraceptive implants and domestic implants similar to Norplant on bone mineral density and bone metabolism in female acceptors for 1 year. Bone mineral density (BMD) and bone mineral content (BMC) of lumbar 2-4 and proximal femur of 61 normal women of child-bearing age were measured by dual energy x-ray absorptiometry (DEXA) before and 12 months after implants insertion in both groups. BMD and BMC of lumbar 2-4 in both groups 12 months after implant insertion significantly increased (p < 0.01); with an average increase of 2.40% and 3.34%, respectively in the Norplant implant group, and 2.75% and 4.47%, respectively in the domestic implant group. Urine hydroxyproline and creatinine ratio (Hop/Cr) in the domestic implant group significantly decreased (p < 0.01). There was no significant differences in the effects on BMD and BMC of lumbar spine and femur and on bone metabolism between the two groups of contraceptive implants (p > 0.05). Levonorgestrel releasing contraceptive subdermal implants were not deleterious to the skeleton in women of child-bearing age. There was no significant effect on achieving maximum bone mass in young women. This article presents a prospective, randomized clinical trial concerning the outcome of levonorgestrel-releasing subdermal contraceptive implants on bone density and bone metabolism during a 1-year study in China. A total of 61 women of childbearing age received either Norplant or domestic implants from July to November 1997. A dual energy x-ray absorptiometry before and 12 months after implant insertion was performed to assess the bone mineral density (BMD) and bone mineral content (BMC) of lumbar 2-4 and proximal femur. A significant increase in BMD and BMC (p 0.01) was observed in both groups, with an increase of 2.40% and 3.34%, respectively, in the Norplant group and 2.75% and 4.47%, respectively, in the domestic implant group. Included in the analysis was the measurement of the urine hydroxyproline and creatinine ratio, which was observed to decrease (p 0.01) in the domestic implant group. Insignificant changes in BMD and BMC on lumbar spine and femur were noted among women 35 years of age or older. This study concludes that levonorgestrel releasing contraceptive subdermal implants are not deleterious to the osseous framework of women in childbearing age.
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