Rosenberg Lynn, Zhang Yuqing, Constant Deborah, Cooper Diane, Kalla Asgar A, Micklesfield Lisa, Hoffman Margaret
Slone Epidemiology Center at Boston University, Boston, MA 02215-1201, USA.
Contraception. 2007 Dec;76(6):425-31. doi: 10.1016/j.contraception.2007.08.010. Epub 2007 Nov 9.
Women using injectable progestin contraceptives (IPCs) have lower bone mineral density than nonusers. We assessed whether bone loss is completely reversible after cessation of IPC use, whether different IPCs have different effects and whether effects vary by age at first use.
In a cross-sectional study in Cape Town, South Africa, 3487 premenopausal black and mixed race women aged 18-44 years were interviewed for information on contraceptive history and risk factors for decreased bone mineral density, and ultrasound measurements of the left calcaneus were taken. Adjusted means of the ultrasound measures for categories of IPC use were obtained using multivariable linear regression.
Current users of IPCs had the lowest ultrasound measures, while the measures of women who had ceased IPC use at least 2-3 years previously were similar to or greater than those of never users of IPCs. The effects of depot medroxyprogesterone acetate and norethisterone enanthate were similar. The calcaneus measures were unrelated to age at which use began after control for confounding factors.
The data suggest that bone loss during IPC use is reversible and that this loss of bone is completely recovered several years after cessation of use.
使用注射用孕激素避孕药（IPC）的女性骨矿物质密度低于未使用者。我们评估了停用IPC后骨质流失是否完全可逆，不同的IPC是否有不同的影响，以及这些影响是否因首次使用时的年龄而异。
在南非开普敦进行的一项横断面研究中，对3487名年龄在18 - 44岁的绝经前黑人和混血女性进行了访谈，以获取避孕史和骨矿物质密度降低的风险因素信息，并对左侧跟骨进行了超声测量。使用多变量线性回归获得IPC使用类别超声测量的调整均值。
当前使用IPC的女性超声测量值最低，而至少在2 - 3年前停用IPC的女性的测量值与从未使用过IPC的女性相似或更高。醋酸甲羟孕酮长效注射液和庚酸炔诺酮的效果相似。在控制混杂因素后，跟骨测量值与开始使用的年龄无关。
数据表明，使用IPC期间的骨质流失是可逆的，并且在停用几年后这种骨质流失会完全恢复。
