Mark S
Department of Internal Medicine (Endocrinology), University of California, San Francisco 94143.
Int J Gynaecol Obstet. 1994 Dec;47(3):269-72. doi: 10.1016/0020-7292(94)90572-x.
A 39-year-old woman on depot medroxyprogesterone acetate for 17 years developed multiple fractures after falling from a stationary horse. Densitometry revealed significant osteopenia. Although the reported patient was a thin, Caucasian woman, she did not have any other significant risk factors for osteoporosis except for a possible state of partial estrogen deficiency induced by the use of depot medroxyprogesterone acetate. Studies have shown that the estradiol levels of premenopausal women who have received this hormonal contraceptive for more than 1 year never reach those seen in the mid-cycle or luteal phase of the normal menstrual cycle. The estradiol levels are comparable only with those found in the early follicular phase. Therefore, women who use depot medroxyprogesterone acetate are in a state of partial estrogen deficiency, which may be associated with increased bone loss.
一名39岁的女性使用醋酸甲羟孕酮长效避孕针17年后，从静止的马背上摔下后发生多处骨折。骨密度测定显示有明显的骨质减少。尽管该报告病例是一名身材消瘦的白人女性，但除了使用醋酸甲羟孕酮长效避孕针可能导致的部分雌激素缺乏状态外，她没有其他明显的骨质疏松风险因素。研究表明，接受这种激素避孕药物超过1年的绝经前女性的雌二醇水平从未达到正常月经周期中周期或黄体期的水平。其雌二醇水平仅与卵泡早期的水平相当。因此，使用醋酸甲羟孕酮长效避孕针的女性处于部分雌激素缺乏状态，这可能与骨质流失增加有关。
