Recovery of bone density in women who stop using medroxyprogesterone acetate

Abstract

In order to determine whether the loss in bone density seen in users of depot medroxyprogesterone acetate is reversible, a comparative study was undertaken in three groups of women. Group 1 consisted of 14 women who had used the contraceptive for at least 3 years and then discontinued use. Group 2 was 22 longterm users, and Group 3 contained 18 women who had never used the drug and served as controls. Estrogen production resumed in all of the Group 1 women after discontinuation. Two bone density measurements were taken twice in each woman. At first measurement, lumbar spine density was an average of 9% lower in Groups 1 and 2 than in controls. At the second measurement, however, lumbar spine density had significantly increased in Group 1 while it remained the same for the other groups. No significant changes in femoral neck density were observed. Additional measurements in 8 women from Group 1 taken 2 years after discontinuation revealed a further significant increase in lumbar spine bone density. Thus, it was concluded that bone density loss is reversible, even in cases where women experience a significant weight loss after discontinuation.