Depot medroxyprogesterone acetate use after peak bone mass is associated with increased bone turnover but no decrease in bone mineral density

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. (Fertil Steril (R) 2010;93:697-701. (C)2010 by American Society for Reproductive Medicine.)