Although the makers of the contraceptive Depo-Provera were required in November to post additional health warnings about possible permanent bone density loss, a new study suggests those effects might be reversible.
The U.S. Food and Drug Administration required Pfizer Inc., the company that makes Depo-Provera, to include a warning recommending health care providers not allow patients to use the contraceptive for more than two years because of the significant bone density loss. The warning also said the bone loss is greater with increasing duration of use and might not be completely reversible.
But the study, published in the February issue of the Archives of Pediatrics & Adolescent Medicine, found that after discontinued use of the product, subjects were able to substantially recover bone density.
The study, which included 80 teenagers, ages 14 to 18, who were beginning to use the product, could not determine if those who participated were able to reach their potential bone density after discontinuing use.
An Phan, a Depo-Provera spokeswoman from Pfizer, said the company is confident that doctors are still comfortable prescribing the product, and consumers are still comfortable taking it.
"The product is so highly efficient," Phan said. "People still trust Depo-Provera for what it needs to do."
The effects of Depo-Provera have been known for years, and health professionals have encouraged women who used the injected contraceptive to take calcium supplements to offset the bone loss caused by the progesterone, said Kathy Fahl, director of Planned Parenthood Mid-Michigan Alliance.
"The reality is, except for abstinence, all forms of birth control have side effects," Fahl said. "People have to decide if they're willing to deal with those or not."
Depo-Provera was a good long-term method because it wasn't a daily method, said Olin Health Center health educator Nicolle Stec. For women who used Depo-Provera for two years, they will have to find another form of birth control because there is no other injected method on the market, Stec said.
"When people come in, (health providers) are giving them one more shot and giving them contraceptive counseling to find another method," Stec said.
Recently, Olin posted the warning about Depo-Provera on its Web site. It is important for students to be vigilant consumers, especially when they are putting something into their bodies, said Dennis Martell, coordinator of health education at Olin.
Effectiveness, costs, side effects and usability are four things that need to be taken into account when choosing a contraceptive, he said. Students need to examine effectiveness, which might not take user error into account.
Some of the errors that are commonly made include not strictly adhering to schedule with oral contraceptives, putting condoms on incorrectly or using an expired condom that might break, he said.
All clinicians try to work with each individual case and look at medical history when discussing birth control, Fahl said.
