Prospective study of bone density and estradiol levels of a cohort of adolescent depotmedroxyprogesterone acetate (DMPA) users

2.50
Hdl Handle:
http://hdl.handle.net/10755/156814
Type:
Presentation
Title:
Prospective study of bone density and estradiol levels of a cohort of adolescent depotmedroxyprogesterone acetate (DMPA) users
Abstract:
Prospective study of bone density and estradiol levels of a cohort of adolescent depotmedroxyprogesterone acetate (DMPA) users
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:June, 2001
Author:Busen, Nancy
OBJECTIVE: To report preliminary data on bone density and estradiol levels in a cohort of adolescent DMPA users after one year of continuous use. DESIGN: This is a descriptive, prospective study of a cohort of 26 adolescent females (age 14-19) recruited from a teen clinic who met inclusion criteria of no hormonal use within three months prior to initiation of DMPA for contraception and no medical condition that would have an effect on bone mineralization. Six (6) subjects remained on DMPA at one year. Estradiol levels were drawn at initiation and one year continuous use of DMPA and were analyzed by RIA using Abbott technology. DEXA scans of L1-L4, greater trochanter, and femoral neck were completed within one month of DMPA initiation and were repeated at one year. Paired T-tests were used to examine differences in bone density from baseline to one year. RESULTS: Of the twenty-six teens recruited, 22 completed the DEXA scan but, consistent with the literature on DMPA drug continuance, only 6 (21%) of the cohort remained on the drug at the end of one year. While the small sample size reduced the power of the study, valuable information was gained regarding bone density with continuous DMPA use by adolescent women at the end of one year. All six subjects reported use of at least 800-1200 mg extra calcium intake per day in addition to food intake. The mean femoral neck bone density of the group at one year (most highly correlated with predicting osteoporosis) was -3.31% with a range from -1.16 to -7.42% which resulted in a t=3.124 and a significant p value of .0261. The mean L1-L4 bone density at one year was -3.52 with a range from +.086 to -6.39 which resulted in a t=3.379 and a significant p value of .0197. At baseline the estradiol levels of the six subjects ranged from 13-166 pg/dl. Four of six subjects had estradiol levels analyzed at one year ranging from 10-35 pg/dl. The subjects ages are 15, 16, 16, 18, 18, 19. These 6 adolescent women had weight changes in one year ranging from -1 pound to +28 pounds. Of the 20 DMPA users who did not continue on the drug for one year and could be followed, 11 (42%) did not return for the 2nd injection. The majority of these users complained of irregular bleeding (n=8, 30%) or weight gain (n=7, 27%). CONCLUSIONS: Significant bone loss occurred in a cohort of adolescent women, who continued on DMPA for one year, during a developmental phase when bone acquisition would be expected. These findings are congruent with Cromer's (1996) study of teens on DMPA, Norplant, and OCP's. Estradiol levels at one year are lower than would be expected in the luteal phase of the menstrual cycle. Further study of adolescent female bone density on DMPA is indicated in a larger prospective sample and with the inclusion of a control group in order to determine predictors of bone loss using DMPA and to determine clinical management strategies for bone acquisition and maintenance in female adolescents using DMPA over time.
Repository Posting Date:
26-Oct-2011
Date of Publication:
Jun-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleProspective study of bone density and estradiol levels of a cohort of adolescent depotmedroxyprogesterone acetate (DMPA) usersen_GB
dc.identifier.urihttp://hdl.handle.net/10755/156814-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Prospective study of bone density and estradiol levels of a cohort of adolescent depotmedroxyprogesterone acetate (DMPA) users</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">June, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Busen, Nancy</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">nbusen@son1.nur.uth.tmc.edu</td></tr><tr><td colspan="2" class="item-abstract">OBJECTIVE: To report preliminary data on bone density and estradiol levels in a cohort of adolescent DMPA users after one year of continuous use. DESIGN: This is a descriptive, prospective study of a cohort of 26 adolescent females (age 14-19) recruited from a teen clinic who met inclusion criteria of no hormonal use within three months prior to initiation of DMPA for contraception and no medical condition that would have an effect on bone mineralization. Six (6) subjects remained on DMPA at one year. Estradiol levels were drawn at initiation and one year continuous use of DMPA and were analyzed by RIA using Abbott technology. DEXA scans of L1-L4, greater trochanter, and femoral neck were completed within one month of DMPA initiation and were repeated at one year. Paired T-tests were used to examine differences in bone density from baseline to one year. RESULTS: Of the twenty-six teens recruited, 22 completed the DEXA scan but, consistent with the literature on DMPA drug continuance, only 6 (21%) of the cohort remained on the drug at the end of one year. While the small sample size reduced the power of the study, valuable information was gained regarding bone density with continuous DMPA use by adolescent women at the end of one year. All six subjects reported use of at least 800-1200 mg extra calcium intake per day in addition to food intake. The mean femoral neck bone density of the group at one year (most highly correlated with predicting osteoporosis) was -3.31% with a range from -1.16 to -7.42% which resulted in a t=3.124 and a significant p value of .0261. The mean L1-L4 bone density at one year was -3.52 with a range from +.086 to -6.39 which resulted in a t=3.379 and a significant p value of .0197. At baseline the estradiol levels of the six subjects ranged from 13-166 pg/dl. Four of six subjects had estradiol levels analyzed at one year ranging from 10-35 pg/dl. The subjects ages are 15, 16, 16, 18, 18, 19. These 6 adolescent women had weight changes in one year ranging from -1 pound to +28 pounds. Of the 20 DMPA users who did not continue on the drug for one year and could be followed, 11 (42%) did not return for the 2nd injection. The majority of these users complained of irregular bleeding (n=8, 30%) or weight gain (n=7, 27%). CONCLUSIONS: Significant bone loss occurred in a cohort of adolescent women, who continued on DMPA for one year, during a developmental phase when bone acquisition would be expected. These findings are congruent with Cromer's (1996) study of teens on DMPA, Norplant, and OCP's. Estradiol levels at one year are lower than would be expected in the luteal phase of the menstrual cycle. Further study of adolescent female bone density on DMPA is indicated in a larger prospective sample and with the inclusion of a control group in order to determine predictors of bone loss using DMPA and to determine clinical management strategies for bone acquisition and maintenance in female adolescents using DMPA over time.</td></tr></table>en_GB
dc.date.available2011-10-26T15:09:51Z-
dc.date.issued2001-06en_GB
dc.date.accessioned2011-10-26T15:09:51Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.