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24-01-2010 | Gynaecology | Article

Smoking, calcium intake, parity associated with DMPA-induced bone loss


Journal abstract

MedWire News: Depotmedroxyprogesterone acetate (DMPA)-associated bone mineral density (BMD) loss can be ameliorated by quitting smoking and increasing calcium intake, suggest US researchers.

“Information is lacking on clinically important predictors of higher bone loss [with DMPA use] which could be used in clinical practice,” say Mahbubur Rahman and Abbey Berenson, both from The University of Texas in Galveston.

The team therefore assessed BMD at the lumbar spine and femoral neck every 6 months in 95 White, African-American, and Hispanic women aged 23.8 years on average, who used DMPA during a 24-month follow-up period.

Overall, 47.4 percent of users had higher BMD loss—defined as at least 5 percent loss from baseline after 24 months use—at the lumbar spine or femoral neck at the end of follow-up.

Multivariate regression analysis revealed that that higher BMD loss was associated with current smoking (adjusted odds ratio [aOR] = 3.88), calcium intake (aOR per 100 mg/day = 0.81), and parity (aOR = 0.49). Specifically, those who had delivered a child, did not smoke, and consumed at least 600 mg/day of calcium did not lose more than 2 percent of their BMD over the 24 months.

Age, race or ethnicity, previous contraceptive use, and body mass index were not associated with high BMD loss.

Rahman and Berenson call for additional counseling on how to reduce the risk for BMD loss with DMPA use in women with the identified risk factors.

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Ingrid Grasmo