Westhoff Carolyn
Department of Obstetrics and Gynecology, Columbia University, 630 West 168th Street, New York, NY 10032, USA.
J Reprod Med. 2002 Sep;47(9 Suppl):795-9.
The relationship between depot medroxyprogesterone acetate (DMPA) and changes in bone mineral density remains controversial despite a substantial number of studies evaluating this potential association and its clinical relevance. While the majority of prospective studies suggest that DMPA produces a modest decline in bone density, several have failed to confirm this association, and none have documented any clinical consequences. The most recent data indicate that if bone density loss does occur in the presence of DMPA, it is reversible and unlikely to adversely influence clinical events either acutely or at a later time, such as in the postmenopausal period. In a risk:benefit evaluation, it is appropriate to consider any relationship between DMPA and changes in bone mineral density in the context of its established efficacy in pregnancy prevention.
尽管有大量研究评估醋酸甲羟孕酮长效注射剂（DMPA）与骨密度变化之间的潜在关联及其临床相关性，但二者之间的关系仍存在争议。虽然大多数前瞻性研究表明，DMPA会使骨密度出现适度下降，但也有一些研究未能证实这种关联，而且没有一项研究记录到任何临床后果。最新数据表明，如果在使用DMPA的情况下确实发生了骨密度损失，那么这种损失是可逆的，不太可能在急性阶段或之后（如绝经后期）对临床事件产生不利影响。在进行风险效益评估时，鉴于DMPA在预防妊娠方面已确立的疗效，考虑其与骨密度变化之间的任何关系是恰当的。
