Depo-Provera: It’s Detrimental Effects on Bone Health
Should there be an age restriction on its prescribing to teens
who have yet to reach optimal bone mineral density?
9. selfchosen to use DepoProvera for any reason.
● Study length of at least 24 months.
● Prior studies must have measured baseline bone mineral density (BMD) with Dual
Energy XRay Absorptiometry (DEXA) and follow up scans at predetermined
intervals.
● Prior studies should have occurred in an outpatient setting with healthy individuals.
● Studies involving individuals with prior bone health issues including but not limited to
osteoporosis, Paget’s disease, osteoarthritis, osteogenesis imperfecta,
rheumatoid arthritis, bone cancer, or leukemia were excluded, as well as studies
with subjects using medications known to affect bone density including chronic
corticosteroids, albuterol inhalers or bone enhancing medications such as Boniva.
● All studies included took place within the last 10 years (20032013).
● Prior studies must have been performed in scientific format, were peer reviewed,
the full text was retrievable, and were written in English.
Table 2. Summary of Included Studies
Source Setting Number
Subjects
Age
Range of
Subjects
Inclusion Criteria
1 Busen et al., J
Adolescent Health,
2003
Outpatient 22 1519 DepoProvera; BMD
measured with DEXA
2 LaraTorre et al., J Outpatient 148 1121 DepoProvera; BMD
10. Pediatr Adolesc
Gynecol, 2004
measured with DEXA
3 Rome et al., J Pediatr
Adolesc Gynecol, 2004
Outpatient 370 1218 DepoProvera; BMD
measured with DEXA
4 Cromer et al., J
Adolescent Health,
2004
Outpatient 215 1218 DepoProvera; BMD
measured with DEXA
5 Cromer, B., Clin Rev
Bone Miner Metab,
2004
N/A
Literature
Review
N/A N/A Previous 10 years
relationship between
DMPA and BMD
6 Beksinska et al.,
Contraception, 2007
Outpatient 490 1519 DepoProvera; BMD
measured with DEXA
7 Cromer et al., Fertil
Steril, 2008
Outpatient 433 1218 DepoProvera; BMD
measured with DEXA
8 Johnson et al.,
Contraception, 2008
Outpatient 389 1118 DepoProvera; BMD
measured with DEXA
9 Beksinska et al.,
Contraception, 2009
Outpatient 490 1519 Follow up of #6
10 Harel et al., J Pediatr
Adolesc Gynecol,
2010b
Outpatient 15 1218 DepoProvera; BMD
measured with DEXA
11 Harel et al.,
Contraception, 2010a
Outpatient 98 1218 Follow up of #8
12 Harel et al.,
Contraception, 2010c
Outpatient 181 1218 Follow up of #8
13 Bonny et al., J Pediatr
Adolesc Gynecol, 2011
Outpatient Not given 1218 DepoProvera; BMD
measured with DEXA
14 Nappi et al.,
Contraception, 2012
Systematic
Review
N/A N/A Effects of hormonal
contraception on
bone metabolism
15 Zhang et al., Chin. Med.
J, 2013
Not
mentioned
199 1618 DepoProvera; BMD
measured with DEXA
24. APPENDIX A:
Data Extraction List:
● Author (s)
● Title
● Database
● Name of journal
● Objective/Goal
● Inclusion Criteria
● Exclusion Criteria
● Include? Y/N
● Type and length of research/methodology
● Number of Subjects
● Age range of subjects
● Setting
● Actual Findings
● Reported Findings
● Support Vs. Challenge
● Limitations
● Link/DOI/PubMedID