Exploratory study of the effect of lifestyle counselling on bone mineral density and body composition in users of the contraceptive depot-medroxyprogesterone acetate

Author(s)

Modesto, Waleska ^[1] ; Valeria Bahamondes, M. ^[1] ; dos Santos, Priscila Silva ^[1] ; Fernandes, Arlete ^[1] ; Dal'Ava, Natalia ^[1] ; Bahamondes, Luis ^[1]

Affiliation

^[1] Univ Estadual Campinas, UNICAMP, Natl Inst Hormones & Womens Hlth, Campinas, SP - Brazil

• Document type: Journal article
• Source: EUROPEAN JOURNAL OF CONTRACEPTION AND REPRODUCTIVE HEALTH CARE; v. 19, n. 4, p. 244-249, AUG 2014.
• Web of Science Citations: 5

Abstract

Objectives To compare variations in bone mineral density (BMD) and body composition (BC) in depot-medroxyprogesterone acetate (DMPA) users and nonusers after providing counselling on healthy lifestyle habits. Methods An exploratory study in which women aged 18 to 40 years participated: 29 new DMPA users and 25 new non-hormonal contraceptive users. All participants were advised on healthy lifestyle habits: sun exposure, walking and calcium intake. BMD and BC were assessed at baseline and 12 months later. Statistical analysis included the Mann-Whitney test or Student's t-test followed by multiple linear regression analysis. Results Compared to the controls, DMPA users had lower BMD at vertebrae L1 and L4 after 12 months of use. They also had a mean increase of 2 kg in total fat mass and an increase of 2.2% in body fat compared to the non-hormonal contraceptive users. BMD loss at L1 was less pronounced in DMPA users with a calcium intake >= 1 g/day compared to DMPA users with a lower calcium intake. Conclusions DMPA use was apparently associated with lower BMD and an increase in fat mass at 12 months of use. Calcium intake >= 1 g/day attenuates BMD loss in DMPA users. Counselling on healthy lifestyle habits failed to achieve its aims. (AU)

• FAPESP's process: 11/01554-4 - Body composition and bone mineral density in users of depot medroxyprogesterone acetate compared to CIU Tcu380A Intrauterine Device
• Grantee: Waleska Oliveira Modesto
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 09/53293-0 - Prospective study for evaluation of the insulin resistance, lipid metabolism and sub clinical cardiovascular disease in women who initiate the depot-medroxyprogesterone acetate (DMP A) contraceptive method with in follow-up for two years. (Project of scientific research)
• Grantee: Luis Guillermo Bahamondes
• Support Opportunities: Research Grants - Research in Public Policies for the National Health Care System (PP-SUS)