Densidade mineral óssea em usuárias e ex-usuárias do contraceptivo injetável com acetato de medroxiprogesterona de depósito / Bone mineral density in users or ex-users of the injectable contraceptive depot medroxyprogesterone acetate


IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia




Objectives: Assess bone mineral density (BMD) in users for at least a year and ex-users in injectable contraceptive postmenopausal with medroxyprogesterone acetate depot (DMPA). Subjects and methods: Two studies have been conducted, both transversal cutting with current users of reproductive age of DMPA and another with postmenopausal women who have used DMPA until menopause. Each user was compared with a woman never using DMPA, the same age (± 1) and the same body mass index (2kg/m) (± 1). In them, were measures the DMO in distal portion and ultra-distal of non-dominant forearm radio technique by DXA (double X-ray absoptiometry). In the first study were incorporated into 232 women users of DMPA and an equal number who used intrauterine device (IUD) TCu380A as control group. Women were divided into 5 groups (1-5) in accordance with the usage time of DMPA: 1 -3; 4-6; 7-9; 10-12 and 13-15 years, respectively. In the second study were incorporated into 79 women with up to 5 years since menopause, being 24 ex-users of DMPA until menopause and 55 ex-users IUD TCu380A also until menopause and who had previously evaluated the DMO to 1-2 and 3 years after menopause. Results: in the first study, the average age (± EPM) of users of DMPA and IUD was 38.1 and 38.3 ± 0.5 ± 0.57 years and average BMI (body mass index) (kg/m2) (± EPM) was 0.3 ± ± 26.3 and 26.4 0.3 (kg/m2) for each group, respectively The users of both groups with little time using the methods were younger than those who used over a long period of time, and both groups had lower BMI in the first 5 years of use. Parity, color, physical activity practice manually were significantly higher in the Group of IUD users (p <0.053, p<0.040 and p<0.012), and the Act of washing clothes, in the users of DMPA (p <0.025). The other demographic and anthropometric data partners did not show significant differences obstetric. The average of the DMO in the distal region of the ultra-distal and radio were similar between the users of DMPA and IUD users, except for DMPA with more than 13 years of use with DMO had significantly lower (p <0.041 and 0.042, respectively). There was no direct relation in two groups between the DMO and the BMI (kg/m2) and inverse relationship between DMO and age, in the region and distal radio ultra-distal. In second study, the time using both contraceptives was 9.4 ± 3.8 and 14.7 ± 6.2 years for DMPA and IUD, respectively. The DMO in distal region in the years 1; 2-3 and 5-6 after menopause was 0.426 and 0.445; 0.434 and 0.421 and 0.437 and requirements in 0.427 DMPA and IUD, respectively. In the ultra-distal region the figures were: 0.350 and 0.380; 0.360 and 0.367 and 0.388 0.373, respectively, and all without statistical significance. Conclusion: No deleterious effects on the DMO requirements in forearm DMPA, with the exception of those who have used for over 13 years, or DMPA ex-users were in post-menopausal women, compared the IUD users. Also we see a direct relationship between the DMO and BMI (kg/m2) and indirectly between DMO and age


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