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→Benefits: antibiotics are stated as issue for COCP in BNF and current UK FPA website, so restore advice, but add (hopefully not excessive) footnote as to discrepency with research
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→Disadvantages & side effects: read carefully--says "in about 10 months," not within 10 months...
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*Unlike [[oral contraceptive]] pills which have to be taken at roughly the same time each day ([[Combined Oral Contraceptive Pill]] within 12 hours and [[Progesterone only pill]] within 3 hours), the effectiveness of Depo Provera is not dependent upon the ability to remember to take daily doses. The only continuing action is to book subsequent follow-up injections every twelve weeks.
*Unlike [[oral contraceptive]] pills which have to be taken at roughly the same time each day ([[Combined Oral Contraceptive Pill]] within 12 hours and [[Progesterone only pill]] within 3 hours), the effectiveness of Depo Provera is not dependent upon the ability to remember to take daily doses. The only continuing action is to book subsequent follow-up injections every twelve weeks.


*It is not affected by absorption issues ([[diarrhea]], vomiting, bowel disorders) nor by antibiotic effects on the normal [[Bacteria in the human body|gut bacterial flora]].<!--
* Unlike the pill, the efficacy of Depo is not affected by absorption issues ([[diarrhea]], vomiting, bowel disorders. <!--
--><ref>The effects of broad-spectrum antibiotics on Combined contraceptive pills is not found on systematic interaction metanalysis (Archer, 2002), although "individual patients do show large decreases in the plasma concentrations of ethinyl estradiol when they take certain other antibiotics" (Dickinson, 2001). "...experts on this topic still recommend informing oral contraceptive users of the potential for a rare interaction" (DeRossi, 2002) and this remains current (2006) UK [http://www.fpa.org.uk/guide/contracep/compill.htm#17 Family Planning Association advice].
--><ref>The effects of broad-spectrum antibiotics on Combined contraceptive pills is not found on systematic interaction metanalysis (Archer, 2002), although "individual patients do show large decreases in the plasma concentrations of ethinyl estradiol when they take certain other antibiotics" (Dickinson, 2001). "...experts on this topic still recommend informing oral contraceptive users of the potential for a rare interaction" (DeRossi, 2002) and this remains current (2006) UK [http://www.fpa.org.uk/guide/contracep/compill.htm#17 Family Planning Association advice].
*{{cite journal | author = Archer J, Archer D | title = Oral contraceptive efficacy and antibiotic interaction: a myth debunked. | journal = J Am Acad Dermatol | volume = 46 | issue = 6 | pages = 917-23 | year = 2002 | id = PMID 12063491}}
*{{cite journal | author = Archer J, Archer D | title = Oral contraceptive efficacy and antibiotic interaction: a myth debunked. | journal = J Am Acad Dermatol | volume = 46 | issue = 6 | pages = 917-23 | year = 2002 | id = PMID 12063491}}
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*{{cite journal | author = DeRossi S, Hersh E | title = Antibiotics and oral contraceptives. | journal = Dent Clin North Am | volume = 46 | issue = 4 | pages = 653-64 | year = 2002 | id = PMID 12436822}}</ref>
*{{cite journal | author = DeRossi S, Hersh E | title = Antibiotics and oral contraceptives. | journal = Dent Clin North Am | volume = 46 | issue = 4 | pages = 653-64 | year = 2002 | id = PMID 12436822}}</ref>


*It is not thought associated with any increased risk of ovarian, liver or cervical cancer and there may even be a prolonged protective effect in reducing the risk of endometrial cancer.<!--
* Depo may be associated with a lower incidence of endometrial cancer.<!--
--><ref name="BrJFP_Bigrigg1999">{{cite journal | author = Bigrigg A, Evans M, Gbolade B, Newton J, Pollard L, Szarewski A, Thomas C, Walling M | title = Depo Provera. Position paper on clinical use, effectiveness and side effects. | journal = Br J Fam Plann | volume = 25 | issue = 2 | pages = 69-76 | year = 1999 | id = PMID 10454658}}</ref><!--
--><ref name="BrJFP_Bigrigg1999">{{cite journal | author = Bigrigg A, Evans M, Gbolade B, Newton J, Pollard L, Szarewski A, Thomas C, Walling M | title = Depo Provera. Position paper on clinical use, effectiveness and side effects. | journal = Br J Fam Plann | volume = 25 | issue = 2 | pages = 69-76 | year = 1999 | id = PMID 10454658}}</ref><!--
--> Such effects are thought due to the reduced exposure to estrogen. (In monkey studies, however, Depo is associated with a higher risk for endometrial cancer.)
--> Such effects are thought due to the reduced exposure to estrogen. (In monkey studies, however, Depo is associated with a higher risk for endometrial cancer.)
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*Depo Provera, like [[progestin]]-only pills, may be used by breast-feeding mothers. Heavy bleeding is possible if given in the immediate [[postpartum]] time and is best delayed until six weeks after birth. It may be used within five days if not breast feeding. Whilst a small study "showed no significant difference in birth weights or incidence of birth defects" and "no significant alternation of immunity to infectious disease caused by breast milk containing DMPA", a possible subgroup of babies with 75% higher incidence of infectious disease was seen in mothers who started Depo_provera at 2 days postpartum.<!--
*Depo Provera, like [[progestin]]-only pills, may be used by breast-feeding mothers. Heavy bleeding is possible if given in the immediate [[postpartum]] time and is best delayed until six weeks after birth. It may be used within five days if not breast feeding. Whilst a small study "showed no significant difference in birth weights or incidence of birth defects" and "no significant alternation of immunity to infectious disease caused by breast milk containing DMPA", a possible subgroup of babies with 75% higher incidence of infectious disease was seen in mothers who started Depo_provera at 2 days postpartum.<!--
--><ref>{{cite journal | author = Dahlberg K | title = Some effects of depo-medroxyprogesterone acetate (DMPA): observations in the nursing infant and in the long-term user. | journal = Int J Gynaecol Obstet | volume = 20 | issue = 1 | pages = 43-8 | year = 1982 | id = PMID 6126406}}</ref><!--
--><ref>{{cite journal | author = Dahlberg K | title = Some effects of depo-medroxyprogesterone acetate (DMPA): observations in the nursing infant and in the long-term user. | journal = Int J Gynaecol Obstet | volume = 20 | issue = 1 | pages = 43-8 | year = 1982 | id = PMID 6126406}}</ref><!--
--> A larger study with longer follow-up concluded that ''"use of DMPA during pregnancy or breastfeeding does not adversely affect the long-term growth and development of children"''.<!--
--> A larger study with longer follow-up concluded that ''"use of DMPA during pregnancy or breastfeeding does not adversely affect the long-term growth and development of children"''. This study also noted that "children with DMPA exposure during pregnancy and lactation had an increased risk of suboptimal growth in height," but that "after adjustment for socioeconomic factors by multiple logistic regression, there was no increased risk of impaired growth among the DMPA-exposed children." "Unfavorable socioeconomic factors" may therefore result in suboptimal height for DMPA-exposed children. The study also noted that effects of DMPA exposure on puberty require further study, as so few children over the age of 10 were observed.<!--
--><ref>{{cite journal | author = Pardthaisong T, Yenchit C, Gray R | title = The long-term growth and development of children exposed to Depo-Provera during pregnancy or lactation. | journal = Contraception | volume = 45 | issue = 4 | pages = 313-24 | year = 1992 | id = PMID 1387602}}</ref>
--><ref>{{cite journal | author = Pardthaisong T, Yenchit C, Gray R | title = The long-term growth and development of children exposed to Depo-Provera during pregnancy or lactation. | journal = Contraception | volume = 45 | issue = 4 | pages = 313-24 | year = 1992 | id = PMID 1387602}}</ref>


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*For some women, Depo-Provera may have a number of potentially intolerable side effects, including loss of interest in sexual activity, infertility, severe headaches, constant bleeding ([[metrorrhagia]]), weight gain, panic attacks, muscle pain, heart palpitations, pain during sex, acne, irregular menstrual bleeding, abdominal cramps, dizziness, weakness or fatigue, leg cramps, nausea, vaginal discharge or irritation, breast swelling and tenderness, bloating, swelling of the hands or feet, backache, depression,insomnia, pelvic pain, no hair growth or excessive hair loss, rash, hot flashes,joint pain, convulsions, jaundice, urinary tract infections, allergic reactions, fainting, paralysis, osteoporosis, lack of return to fertility, deep vein thrombosis, and pulmonary embolus.<ref name="Patient labeling">{{cite web | title=Depo Provera - Patient labeling | year=2004 | month=October | publisher=Pfizer | url=http://64.233.187.104/search?q=cache:ncypxLIp_NIJ:www.pfizer.com/pfizer/download/ppi_depo_provera_contraceptive.pdf+depo+provera+%2B+patient+information&hl=en&gl=us&ct=clnk&cd=1 | format=[http://www.pfizer.com/pfizer/download/ppi_depo_provera_contraceptive.pdf PDF original]}}</ref>
*For some women, Depo-Provera may have a number of potentially intolerable side effects, including loss of interest in sexual activity, infertility, severe headaches, constant bleeding ([[metrorrhagia]]), weight gain, panic attacks, muscle pain, heart palpitations, pain during sex, acne, irregular menstrual bleeding, abdominal cramps, dizziness, weakness or fatigue, leg cramps, nausea, vaginal discharge or irritation, breast swelling and tenderness, bloating, swelling of the hands or feet, backache, depression,insomnia, pelvic pain, no hair growth or excessive hair loss, rash, hot flashes,joint pain, convulsions, jaundice, urinary tract infections, allergic reactions, fainting, paralysis, osteoporosis, lack of return to fertility, deep vein thrombosis, and pulmonary embolus.<ref name="Patient labeling">{{cite web | title=Depo Provera - Patient labeling | year=2004 | month=October | publisher=Pfizer | url=http://64.233.187.104/search?q=cache:ncypxLIp_NIJ:www.pfizer.com/pfizer/download/ppi_depo_provera_contraceptive.pdf+depo+provera+%2B+patient+information&hl=en&gl=us&ct=clnk&cd=1 | format=[http://www.pfizer.com/pfizer/download/ppi_depo_provera_contraceptive.pdf PDF original]}}</ref>


*Those planning a pregnancy after having used Depo-Provera may wish to switch to alternative contraceptive methods some 6-9 months prior. Whilst it only gives consistent contraception for 12 weeks, and pregnancy is possible after 13 weeks if not repeated in time, fertility may be temporarily reduced in some women for up to 18 months with over half of all women able to conceive within 10months of the last injection.<ref name="Patient labeling"/>
*Those planning a pregnancy after having used Depo-Provera may wish to switch to alternative contraceptive methods some 6-9 months prior. Whilst it only gives consistent contraception for 12 weeks, and pregnancy is possible after 13 weeks if not repeated in time, fertility may be totally suppressed in some women for up to 18 months. %50 of women may be able to conceive in about 10 months from the last injection.<ref name="Patient labeling"/>


*Depo Provera may enhance HIV transmission.<ref>{{cite web | author=Sara Littlecrow-Russell | title=NO. 5 - Time to Take a Critical Look at Depo-Provera | work=Population and Development Program | publisher= Hampshire Colledge | year=2000 | month=Summer | url=http://72.14.209.104/search?q=cache:cib3QTviWbsJ:popdev.hampshire.edu/projects/dt/pdfs/DifferenTakes_05.pdf+depo+provera+%2B+thailand&hl=en&gl=us&ct=clnk&cd=8 | format=[http://popdev.hampshire.edu/projects/dt/pdfs/DifferenTakes_05.pdf PDF original]}}</ref>
*Depo Provera may enhance HIV transmission.<ref>{{cite web | author=Sara Littlecrow-Russell | title=NO. 5 - Time to Take a Critical Look at Depo-Provera | work=Population and Development Program | publisher= Hampshire Colledge | year=2000 | month=Summer | url=http://72.14.209.104/search?q=cache:cib3QTviWbsJ:popdev.hampshire.edu/projects/dt/pdfs/DifferenTakes_05.pdf+depo+provera+%2B+thailand&hl=en&gl=us&ct=clnk&cd=8 | format=[http://popdev.hampshire.edu/projects/dt/pdfs/DifferenTakes_05.pdf PDF original]}}</ref>
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--><ref name="WHO2005">{{cite web | author=World Health Organization | authorlink =World Health Organization | year = 2005 | month =September | url =http://www.who.int/reproductive-health/family_planning/bone_health.html | title =Hormonal contraception and bone health | work =Family Planning | accessdate =2006-05-12}}</ref><!--
--><ref name="WHO2005">{{cite web | author=World Health Organization | authorlink =World Health Organization | year = 2005 | month =September | url =http://www.who.int/reproductive-health/family_planning/bone_health.html | title =Hormonal contraception and bone health | work =Family Planning | accessdate =2006-05-12}}</ref><!--
--><ref name="Contraception2006-Curtis">{{cite journal | author=Curtis KM, Martins SL | title=Progestogen-only contraception and bone mineral density: a systematic review | journal=Contraception | year=2006 | pages=470-87 | volume=73 | issue=5 | id=PMID 16627031}}</ref>
--><ref name="Contraception2006-Curtis">{{cite journal | author=Curtis KM, Martins SL | title=Progestogen-only contraception and bone mineral density: a systematic review | journal=Contraception | year=2006 | pages=470-87 | volume=73 | issue=5 | id=PMID 16627031}}</ref>
Cohort studies have shown that BMD loss is reversible within 30 months of discontinuation of DMPA and that in adolescents the recovery is much quicker.<!--
One cohort study has shown that BMD loss may be reversible within 30 months of discontinuation of DMPA.<!--
--><ref name="Scholes2002">{{cite journal | author=Scholes D, LaCroix AZ, Ichikawa LE, Barlow WE, Ott SM | title=Injectable hormone contraception and bone density: results from a prospective study | journal=Epidemiology | year=2002 | pages=581-7 | volume=13 | issue=5 | id=PMID 12192229}}</ref><!--
--><ref name="Scholes2002">{{cite journal | author=Scholes D, LaCroix AZ, Ichikawa LE, Barlow WE, Ott SM | title=Injectable hormone contraception and bone density: results from a prospective study | journal=Epidemiology | year=2002 | pages=581-7 | volume=13 | issue=5 | id=PMID 12192229}}</ref><!--
--><ref name="Scholes2005">{{cite journal | author=Scholes D, LaCroix AZ, Ichikawa LE, Barlow WE, Ott SM | title=Change in bone mineral density among adolescent women using and discontinuing depot medroxyprogesterone acetate contraception | journal=Arch Pediatr Adolesc Med | year=2005 | pages=139-44 | volume=159 | issue=2 | id=PMID 15699307}}</ref> Pfizer, however, advises in the product insert that bone loss caused by Depo Provera may not be reversible.
--><ref name="Scholes2005">{{cite journal | author=Scholes D, LaCroix AZ, Ichikawa LE, Barlow WE, Ott SM | title=Change in bone mineral density among adolescent women using and discontinuing depot medroxyprogesterone acetate contraception | journal=Arch Pediatr Adolesc Med | year=2005 | pages=139-44 | volume=159 | issue=2 | id=PMID 15699307}}</ref> At least one of the authors of the study, AZ Lacroix, is a consultant for Pfizer. [http://www.annals.org/cgi/content/abstract/139/2/97]The School of Public Health at the University of Washington, where the study was conducted, receives financial support from Pfizer. And Pfizer continues to advise in the Depo product insert that bone loss caused by Depo Provera may not be reversible.


== Other uses ==
== Other uses ==

Revision as of 23:30, 14 August 2006

This redirect is about the contraceptive drug. For the band formerly known as DEPOPROVERA, see Depo (band).
Depot medroxyprogesterone acetate
Background
TypeHormonal
First use1967
Pregnancy rates (first year)
Perfect use0.3%
Typical use0.3%
Usage
Duration effect90 days
(12weeks + 5 days)
Reversibility?-18+months
User remindersMaximum interval is just under 3months
Clinic review12 weeks
Advantages and disadvantages
STI protectionNo
Period disadvantagesEspecially in 1st injection may be frequent spotting
Period advantagesUsually no periods from 2nd injection
Weight gainYes
BenefitsEspecially if poor pill compliance
RisksReduced bone density, breast cancer, cervical cancer
Medical notes
For those intending to start family, suggest switch 6 months prior to alternative method (eg POP) allowing more reliable return fertility.

Depo-Provera Contraceptive Injection (medroxyprogesterone acetate) is the U.S. brand name of a birth control product manufactured by Pfizer Inc. It is a hormonal birth control method containing a synthetic progestin, without estrogen, and is administered to women in the form of an intramuscular injection once every 11 to 13 weeks. Depo-Provera causes the ovaries to stop releasing eggs, and is 99.7% effective at preventing pregnancy.

Benefits

  • Unlike oral contraceptive pills which have to be taken at roughly the same time each day (Combined Oral Contraceptive Pill within 12 hours and Progesterone only pill within 3 hours), the effectiveness of Depo Provera is not dependent upon the ability to remember to take daily doses. The only continuing action is to book subsequent follow-up injections every twelve weeks.
  • Unlike the pill, the efficacy of Depo is not affected by absorption issues (diarrhea, vomiting, bowel disorders. [1]
  • Depo may be associated with a lower incidence of endometrial cancer.[2] Such effects are thought due to the reduced exposure to estrogen. (In monkey studies, however, Depo is associated with a higher risk for endometrial cancer.)
  • Depo Provera, like progestin-only pills, may be used by breast-feeding mothers. Heavy bleeding is possible if given in the immediate postpartum time and is best delayed until six weeks after birth. It may be used within five days if not breast feeding. Whilst a small study "showed no significant difference in birth weights or incidence of birth defects" and "no significant alternation of immunity to infectious disease caused by breast milk containing DMPA", a possible subgroup of babies with 75% higher incidence of infectious disease was seen in mothers who started Depo_provera at 2 days postpartum.[3] A larger study with longer follow-up concluded that "use of DMPA during pregnancy or breastfeeding does not adversely affect the long-term growth and development of children". This study also noted that "children with DMPA exposure during pregnancy and lactation had an increased risk of suboptimal growth in height," but that "after adjustment for socioeconomic factors by multiple logistic regression, there was no increased risk of impaired growth among the DMPA-exposed children." "Unfavorable socioeconomic factors" may therefore result in suboptimal height for DMPA-exposed children. The study also noted that effects of DMPA exposure on puberty require further study, as so few children over the age of 10 were observed.[4]

Disadvantages & side effects

  • Recent research has shown that Depo-Provera significantly decreases bone density in women, as compared with others in the same age group (see below). The manufacturer of Depo Provera does not advise prolonged use (longer than two years). This loss of BMD is of particular concern during adolescence and early adulthood, a critical period of bone accretion. It is unknown if use of Depo Provera by younger women will reduce peak bone mass and increase the risk for osteoporotic fracture in later life.
  • Depo Provera is associated with increased risk of breast cancer, particularly in women under 35, and current or recent users.[5]
  • For some women, Depo-Provera may have a number of potentially intolerable side effects, including loss of interest in sexual activity, infertility, severe headaches, constant bleeding (metrorrhagia), weight gain, panic attacks, muscle pain, heart palpitations, pain during sex, acne, irregular menstrual bleeding, abdominal cramps, dizziness, weakness or fatigue, leg cramps, nausea, vaginal discharge or irritation, breast swelling and tenderness, bloating, swelling of the hands or feet, backache, depression,insomnia, pelvic pain, no hair growth or excessive hair loss, rash, hot flashes,joint pain, convulsions, jaundice, urinary tract infections, allergic reactions, fainting, paralysis, osteoporosis, lack of return to fertility, deep vein thrombosis, and pulmonary embolus.[6]
  • Those planning a pregnancy after having used Depo-Provera may wish to switch to alternative contraceptive methods some 6-9 months prior. Whilst it only gives consistent contraception for 12 weeks, and pregnancy is possible after 13 weeks if not repeated in time, fertility may be totally suppressed in some women for up to 18 months. %50 of women may be able to conceive in about 10 months from the last injection.[6]
  • Depo Provera may enhance HIV transmission.[7]
  • Infants born to women exposed to Depo during pregnancy in one study had an %80 greater chance of dying in the first year of life. [8]
  • A study of 819 women in one city found an association between using Depo-Provera and higher incidence of chlamydia and gonorrhea.[9]

Black box warning

While it has long been known that Depo-Provera causes bone loss, it has recently been discovered that the osteoporotic effects of the injection grow worse the longer Depo-Provera is administered, last long after the injections are stopped, and may be irreversible. For this reason, on November 17, 2004 the United States Food and Drug Administration and Pfizer agreed to put a "black box warning" on Depo-Provera's label.[10] However the WHO (World Health Organization), which has a policy directive to reduce population in developed countries--and which provided Depo-Provera to developed countries when the US FDA refused to approve it for safety reasons pertaining to breast cancer--advises that the use of Depo Provera should not be restricted. [1] [11][12] One cohort study has shown that BMD loss may be reversible within 30 months of discontinuation of DMPA.[13][14] At least one of the authors of the study, AZ Lacroix, is a consultant for Pfizer. [2]The School of Public Health at the University of Washington, where the study was conducted, receives financial support from Pfizer. And Pfizer continues to advise in the Depo product insert that bone loss caused by Depo Provera may not be reversible.

Other uses

Depo-Provera is also used with male sex offenders as a form of chemical castration as it has the effect of drastically reducing sex drive in males. [3]

Footnotes

  1. ^ The effects of broad-spectrum antibiotics on Combined contraceptive pills is not found on systematic interaction metanalysis (Archer, 2002), although "individual patients do show large decreases in the plasma concentrations of ethinyl estradiol when they take certain other antibiotics" (Dickinson, 2001). "...experts on this topic still recommend informing oral contraceptive users of the potential for a rare interaction" (DeRossi, 2002) and this remains current (2006) UK Family Planning Association advice.
    • Archer J, Archer D (2002). "Oral contraceptive efficacy and antibiotic interaction: a myth debunked". J Am Acad Dermatol. 46 (6): 917–23. PMID 12063491.
    • Dickinson B, Altman R, Nielsen N, Sterling M (2001). "Drug interactions between oral contraceptives and antibiotics". Obstet Gynecol. 98 (5 Pt 1): 853–60. PMID 11704183.{{cite journal}}: CS1 maint: multiple names: authors list (link)
    • DeRossi S, Hersh E (2002). "Antibiotics and oral contraceptives". Dent Clin North Am. 46 (4): 653–64. PMID 12436822.
  2. ^ Bigrigg A, Evans M, Gbolade B, Newton J, Pollard L, Szarewski A, Thomas C, Walling M (1999). "Depo Provera. Position paper on clinical use, effectiveness and side effects". Br J Fam Plann. 25 (2): 69–76. PMID 10454658.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  3. ^ Dahlberg K (1982). "Some effects of depo-medroxyprogesterone acetate (DMPA): observations in the nursing infant and in the long-term user". Int J Gynaecol Obstet. 20 (1): 43–8. PMID 6126406.
  4. ^ Pardthaisong T, Yenchit C, Gray R (1992). "The long-term growth and development of children exposed to Depo-Provera during pregnancy or lactation". Contraception. 45 (4): 313–24. PMID 1387602.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  5. ^ Gwen Duggan. "Depo-provera and women's health". The Vancouver Sun. {{cite news}}: Unknown parameter |dater= ignored (help) - artilce by Vice-President Women for Women's Health
  6. ^ a b "Depo Provera - Patient labeling" (PDF original). Pfizer. 2004. {{cite web}}: External link in |format= (help); Unknown parameter |month= ignored (help)
  7. ^ Sara Littlecrow-Russell (2000). "NO. 5 - Time to Take a Critical Look at Depo-Provera" (PDF original). Population and Development Program. Hampshire Colledge. {{cite web}}: External link in |format= (help); Unknown parameter |month= ignored (help)
  8. ^ "Exposure to DMPA in pregnancy may cause low birth weight". Prog Hum Reprod Res (23): 2–3. 1992. PMID 12286194.
  9. ^ Morrison CS, Bright P, Wong EL, Kwok C, Yacobson I, Gaydos CA, Tucker HT, Blumenthal PD (2004). "Hormonal contraceptive use, cervical ectopy, and the acquisition of cervical infections". Sex Transm Dis. 31 (9): 561–7. PMID 15480119.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  10. ^ FDA (2004). "Black Box Warning Added Concerning Long-Term Use of Depo-Provera Contraceptive Injection". Retrieved 2006-05-12. {{cite web}}: Unknown parameter |month= ignored (help)
  11. ^ World Health Organization (2005). "Hormonal contraception and bone health". Family Planning. Retrieved 2006-05-12. {{cite web}}: Unknown parameter |month= ignored (help)
  12. ^ Curtis KM, Martins SL (2006). "Progestogen-only contraception and bone mineral density: a systematic review". Contraception. 73 (5): 470–87. PMID 16627031.
  13. ^ Scholes D, LaCroix AZ, Ichikawa LE, Barlow WE, Ott SM (2002). "Injectable hormone contraception and bone density: results from a prospective study". Epidemiology. 13 (5): 581–7. PMID 12192229.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  14. ^ Scholes D, LaCroix AZ, Ichikawa LE, Barlow WE, Ott SM (2005). "Change in bone mineral density among adolescent women using and discontinuing depot medroxyprogesterone acetate contraception". Arch Pediatr Adolesc Med. 159 (2): 139–44. PMID 15699307.{{cite journal}}: CS1 maint: multiple names: authors list (link)


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