How does current DMPA use affect bone mineral density (BMD) in adolescents?
DMPA use during adolescence is associated with decreased bone density in both the spine and the hip (1-2). The rate of bone loss appears to be greatest during the first year of use and may slow with longer use. There have been no randomized control trials looking at the effects on DMPA on bone loss in adolescents. Four prospective, observational studies of adolescents, ages 11-21 years, compared BMD of those who received DMPA injections at 12-week intervals for up to two years versus non-users (3-7). • BMD at the lumbar spine in users of DMPA decreased an average of -3.1% (range -1.5% to -6.0%) compared to an average of +7.2% (range +5.9% to +9.5%) in non- users. • The total average discrepancy in the BMD between DMPA users and non-users was 10.3%. • The BMD decreases were greater in the first year of DMPA use. There are four longitudinal studies in adult women over the age of 18 comparing DMPA users and non-users. All of the studies reported a decrease in BMD among DMPA users compared
