Teenagers Recover Bone Loss After Stopping Use of Injectable Contraceptive Depo-Provera, Study Says

Main Category: Women's Health / Gynecology
Article Date: 10 Feb 2005 - 5:00 PDT


Teenage women who have experienced bone mineral density loss while taking... Pfizer's injectable contraceptive Depo-Provera are able to recover their bone loss after discontinuing use of the contraceptive, according to a study published in the February issue of the Archives of Pediatric and Adolescent Medicine, the Seattle Post-Intelligencer reports (Davidow, Seattle Post-Intelligencer, 2/8). FDA in November 2004 added a black box warning -- the strongest warning a drug can carry -- to the labeling of Depo-Provera because of evidence that extended use of the injectable contraceptive can cause significant bone density loss. The black box warning states that bone density loss increases the longer the drug is used and that the loss is not always completely reversible after use of the drug is discontinued. The labeling warns that Depo-Provera should not be used for longer than two years unless all other contraceptive methods have been deemed inadequate (Kaiser Daily Reproductive Health Report, 11/18/04). Dr. Delia Scholes of the Group Health Cooperative in Seattle and colleagues studied 80 women ages 14 to 18 who were just beginning to use Depo-Provera and 90 women of the same age who did not use the contraceptive, according to the Post-Intelligencer (Seattle Post-Intelligencer, 2/8). The researchers measured all of the participants' bone density at the start of the study and every six months afterward for two to three years, according to the Wall Street Journal (Corbett Dooren, Wall Street Journal, 2/8).

Findings, Conclusions
Over the study period, Depo-Provera users had an average bone density loss of 1.81% in the hip and 0.97% density in the spine, compared with a 0.19% density loss in the hip and a 1.32% density gain in the spine among nonusers (Seattle Post-Intelligencer, 2/8). Women typically continue building bone mass into their teens and 20s, according to the Journal. Despite initial bone density loss, the 61 teenagers who stopped using the contraceptive during the course of the study reversed almost all of the bone density loss after 12 months, according to the Journal (Wall Street Journal, 2/8). On average, teenagers who discontinued Depo-Provera use had a 1.34% density gain in the hip and a 2.86% density gain in the spine after discontinuing treatment (Seattle Post-Intelligencer, 2/8). The researchers noted that although the women who stopped using Depo-Provera regained lost bone density, it is "impossible to determine" what their bone density would have been if they had never used the contraceptive, the Journal reports (Wall Street Journal, 2/8). Scholes said the study's findings "are reassuring for those concerned about the future risk of fractures," adding, "This information can be useful in helping young women balance the need to avoid unintended pregnancies with the need to build strong bones" (Reuters, 2/7). An earlier study conducted by Scholes found that women ages 18 to 39 also recover lost bone density after discontinuing use of Depo-Provera, the Post-Intelligencer reports (Seattle Post-Intelligencer, 2/8).

"Reprinted with permission from kaisernetwork.org kaisernetwork.org. You can view the entire Kaiser Daily Reproductive Health Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/repro The Kaiser Daily Reproductive Health Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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