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Changes in bone mineral density among women aged 19-24 years using injectable contraceptive depot medroxyprogesterone acetate

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Journal of Reproduction and Contraception 2015年第2期26卷 81-89页

作者： Ling GAI Li-hong ZHANG Xue-mei LV Bin WEI Hai-qing DING Jin-yun LIU Hui JIANG Key Laboratory for Improving Birth Outcome Technique Shandong Provincial Institute of Science and Technology for Family Planning the family planning committee of tao luo town in international ocean city of rizhao

Objective To compare bone mineral density （BMD） between users of intramuscular depot medroxyprogesterone acetate （DMPA） and nonhormonal control subjects. Methods The study included 87 women aged between 19 and 24 years using DMPA （DMPA group）for 24 months and 83 same-age women using nonhormonal contraception as control group. BMD of the lumbar spine and femoral neck were measured using dual-energy X-ray absorptiometry, comparing mean BMD changes in DMPA group with the control. Results After 24 months of DMPA treatment, as compared ~ith baseline, the mean BMD in lumbar spine and femoral neck were decreased by 2.67% and 2.71%, respectively. The mean lumbar spine and femoral neck BMD in DMPA group at 24 months were not significantly different compared with baseline （P=0. 080 and P=0. 076, respectively）. In comparison, in control group, there was a trend toward increasing BMD. After 24 months of observation, the mean percentage changes from baseline in lumbar spine and femoral neck BMD were increased by 1.24% and 1.30%, respectively. There was no significantly difference compared with baseline （P=0. 436 and P=0.373, respectively）. Mean BMD at the spine and femoral neck did not differ significantly between DMPA users and nonusers over 12 months （P=0.153 and P=0.140, respectively）, but the BMD at both anatomical sites was significantly lower in DMPA group than in the control after 24 months of treatment （P=0.012 and P=0.008, respectively）. Conclusion The use of DMPA for short-term （≤12-month） had no significant effects on BMD at spine and femoral neck, but long-term exposure to DMPA had significant loss in BMD in women aged between 19 and 24 years.

关键词： depot medroxyprogesterone acetate (DMPA) bone mineral density (BMD) contraception young women

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Effect of depot medroxyprogesterone acetate(DMPA) on bone mineral density(BMD) and evaluating changes in BMD after discontinuation of DMPA in adolescent women

引用

Journal of Reproduction and Contraception 2015年第3期26卷 151-159页

作者： Cheng-wu SHEN Ling GAI Li-hong ZHANG Lin-lin WANG Hai-qing DING Hui JIANG Shandong Provincial Hospital Affiliated to Shandong University Key Laboratory for Improving Birth Outcome Technique Shandong Provincial Institute of Science and Technology for Family Planning the family planning committee of tao luo town in international ocean city of rizhao

Objective To compare bone mineral density （BMD） between users of intramuscular depot medroxyprogesterone acetate （DMPA） and nonhormonal subjects and evaluated the changes in BMD after discontinuation of DMPA.Methods The study included 102 women aged 16-18 years using DMPA for 24 months and 97 same-age nonusers. BMD of the lumbar spine and femoral neck were measured using dual-energy X-ray absorptiometry. The mean BMD values were compared between DMPA users （DMPA group） and nonusers （control group） and the changes of BMD during 36 months after discontinuation of DMPA were observed.Results Mean BMD at the spine and femoral neck did not differ significantly between DMPA group and control group over 12 months, but the BMD values at both anatomical sites were significantly lower in DMPA group than in control group after 24 months treatment. After DMPA discontinuation, the mean BMD values in DMPA users increased substantially. At 24 months after DMPA discontinuation, there were no significant differences between DMPA group and control group. But the values of the lumbar spine and femoral neck BMD in DMPA group were still 1.70% and 1.87%, respectively, below nonusers at 36 months after DMPA discontinuation.Conclusion The use of DMPA for short-term （ ≤12 months） had no significant effects on BMD at spine and femoral neck, but long-term exposure to DMPA had significant loss in BMD in adolescents. Bone loss occurring with DMPA use is reversible after DMPA discontinuation.

关键词： depot medroxyprogesterone acetate (DMPA) bone mineral density (BMD) contraception adolescents

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