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Title: Trabecular bone in long-term depot-medroxyprogesterone acetate users.
Author: Virutamasen P, Wangsuphachart S, Reinprayoon D, Kriengsinyot R, Leepipatpaiboon S, Gua C.
Journal: Asia Oceania J Obstet Gynaecol; 1994 Sep; 20(3):269-74. PubMed ID: 7811192.
Abstract:
A cross-sectional study was designed to determine trabecular bone density in 75 long-term depot-medroxyprogesterone acetate (DMPA) users (> 3 yr) matched with non-DMPA users by age, body mass index (18-25), limitation of age (< 45 yr), and body weight (< 60 kg). The long-term DMPA cases were divided into 3 groups according to duration of injectable contraceptive use. Neither cases nor controls had a smoking or chronic alcohol consumption history. Cases and controls were matched by age. Trabecular bone of the femoral neck were assessed by X-ray and interpreted by a single-blinded radiologist. Trabecular bone patterns were graded according to Singh's Index. Blood collection for determination of estradiol, prolactin, calcium, phosphorus, and medroxyprogesterone acetate were performed in cases and controls. Venous blood was taken at twelfth week of injection of DMPA and within 5 days after menstrual bleeding cessation in the controls. Mean trabecular bone in the cases was 5.5 +/- 0.6 (range 4-6). It was not statistically different from that in the controls (mean 5.5 +/- 0.6, range 2-6). No statistically significant difference of serum, calcium, phosphorus, prolactin, and estradiol was seen in the cases when compared to controls at mid follicular phase of normal menstrual cycle. Serum MPA of individual case at twelfth week of injection was 4.1 +/- 1.1 nmol/l. In conclusion, trabecular bone density in long-term DMPA users were not statistically different from normal menstruating women who have not received injectable DMPA. A cross-sectional study was designed to determine trabecular bone density in 75 long-term depot-medroxyprogesterone acetate (DMPA) users ( 3 years) matched with non-DMPA users by age, body mass index (18-25), limitation of age ( 45 years), and body weight ( 60 kg). The DMPA cases were divided into 3 groups. Group 1 contained women who had used injectable contraceptives for 3-5 years; group 2 comprised women who had used DMPA for 6-7 years; and group 3 consisted of women who had used injectables for more than 7 years. Volunteers received 150 mg (3 ml) of DMPA every 12 weeks. Neither cases nor controls had a smoking or chronic alcohol consumption history. Cases and controls were matched by age. Trabecular bones of the femoral neck were assessed by X-ray and interpreted by a single-blinded radiologist. Trabecular bone patterns were graded according to Singh's Index. Determination of estradiol, prolactin, calcium, phosphorus, and DMPA in blood was performed in cases and controls. Venous blood was taken at the 12th week of injection of DMPA and within 5 days after menstrual bleeding cessation in controls. The mean serum level for calcium ranged from 9.3 to 10.1 mg% and 3.2 to 3.5 mg% for phosphorus. The mean serum level for estradiol in the 3 DMPA user groups ranged from 122.9 pmol/l to 167.7 pmol/l compared to 141.9 pmol/l to 195 pmol/l in controls. Mean trabecular bone in Group 3 of cases (n = 25) was 5.5 +or- 0.6. It was not statistically different from that in the controls (n = 49) (mean 5.5 +or- 0.6). There were no statistically significant differences in serum calcium, phosphorus, prolactin, and estradiol levels in cases compared to controls at the mid-follicular phase of normal menstrual cycle. Individual serum MPA at the 12th week of injection was 4.1 +or- 1.1 nmol/l. Trabecular bone density in long-term DMPA users was not statistically different from normal menstruating women who had not received injectable DMPA.

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