Paper
Thursday, 20 July 2006
This presentation is part of : Strategies Addressing Women's Health Issues
The Effect of Long-Term Depot Medroxyprogesterone (DMPA) use on Bone Mineral Density in Bangladeshi Women Under Age 21
Robin B. Britt, EdD, RNC, College of Nursing, Texas Woman's University, Houston, TX, USA and Nahid J. Rianon, MD, Department of Family Medicine, School of Medicine, University of Texas Health Science Center of Houston, Houston, TX, USA.
Learning Objective #1: describe the effect of long-term DMPA use on the bone density of Bangladeshi women who began use in their adolescent years
Learning Objective #2: formulate solutions for dealing with the inherent problems of conducting international research from afar
PURPOSE:   The purpose of this cross-sectional, descriptive study was to determine if significant bone loss occurred in long-term (>2 years) Bangladeshi DMPA users who began depot medroxyprogesterone (DMPA) use in their adolescent years as compared to a non-hormonal control group matched for ethnicity (Bangladeshi), height, weight, BMI, nutritional diary intake and economic status.

METHODS:  One hundred married women in Dhaka, Bangladesh were recruited for this study.  Participants were clients in two reproductive health clinics who were divided into cases (n =50) (age 15-21) and controls (n = 50) (age 13-21) by DMPA history. A demographic questionnaire and a bone mineral density (BMD) scan were used for data collection.  After consent and questionnaire completion the participants had a bone mineral density (BMD) scan on their hip and spine.

RESULTS:  A t-test revealed both the mean dexa lumbar spine scores (t=.160, df=98, p=.873) and mean femoral scores (t=-.145, df=98, p=.885) were not statistically significantly different. The BMD mean scores of both groups were low but not osteopenic.  A Pearson’s correlation between duration on DMPA and either lumbar dexa (r=.053, p=.716) or femoral dexa score (r=.038, p=.792) showed no relationship.CONCLUSIONS:  These results suggest that in this homogenous sample of adolescents, with low BMD there was no significant difference in BMD and no relationship between time on DMPA and BMD.  These findings conflict with some investigations and concur with others.  Further study is needed to validate the effects of DMPA on bone density in adolescents in both developing and developed countries.

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