Objective: To ascertain whether increased bone turnover in depot medroxyprogesterone acetate (DMPA) users after peak bone mass is associated with bone mineral loss.
Design: Three-year, observational, longitudinal study.
Setting: General practice and family planning clinics.
Patient(s): Women over age 34: established DMPA users (n = 23), discontinuers (n = 14), and controls (n = 27).
Main outcome measure(s): Change in spine and hip bone mineral density (BMD).
Result(s): Despite increased biochemical markers of bone turnover in DMPA users, there was no decrease in BMD. Bone turnover markers did not correlate with change in BMD.
Conclusion(s): In established DMPA users, after peak bone mass, a single normal BMD measurement could provide reassurance for long-term use. Measurement of bone turnover does not predict bone loss in DMPA users.
Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.