Long-term depot-medroxyprogesterone acetate and bone mineral density

The association between long-term use of depot-medroxy-progesterone acetate (DMPA) and bone mineral density (BMD) has been controversial, as seen in t hree case-control studies in New Zealand, Thailand, and the United Kingdom. In the present case-controlled study of BMD, a group of 67 Chinese women w ho had used DMPA from 5-15 years was compared with 218 women of the same ag e range who had not used any steroidal hormones. DMPA users were found to h ave a significantly lower BMD at lumbar vertebra (L2-4) (0.93 g/cm(2)), nec k of femur (0.69 g/cm(2)), trochanter (0.59 g/cm(2)), and Ward's triangle ( 0.58 g/cm(2)), as compared with the control group, whose corresponding BMD values were 1.03 g/cm(2), 0.83 g/cm(,)(2) 0.71 g/cm(2), and 0.78 g/cm(2), r espectively (p <0.001). The average percentage of bone loss per year was es timated to be 1.1% in L2-4, 2.3% in neck of femur, 2.4% in trochanter, and 3.5% in Ward's triangle. The percentage of bone loss in L2-4 was found to b e more pronounced with age. This study provided information that the use of DMPA in a Chinese group for >5 years is associated with bone loss, and a p rospective study is needed to confirm these data, which are different from two case-control studies. (C) 1999 Elsevier Science Inc. All rights reserve d.