Question

What will be done about the depo? I have severe osteopenia and my T score is -2.0. I am only 28. This is a terrible effect of the drug, and I don't think it is fair to have to suffer from it.

Answer

It is very saddening when one finds out a medication they were taking has caused them harm. Although drug companies try to discover all of the harmful side effects of medications, it sometimes takes years to find out all of the effects, both good and bad. This is certainly why the benefits and risks of a medication must be carefully weighed before being prescribed, and it is better to avoid medications when safer, reasonable alternatives are available.

In the case of family planning, the current culture has viewed artificial birth control as the most reasonable, responsible approach to women of child bearing years, even though Depo-Provera injections and birth control pills have several significant health risks. What is not widely known is that the effectiveness of modern natural family planning methods is very comparable to the hormonal contraceptives, is much less expensive, and is without the side effects of the pill and depo. In fact, when you learn to observe your body's signs of fertility, an excellent record reflecting your health is generated, and health risks can be detected quicker.

Regarding Depo-Provera, the National Institute of Health conducted a study published in 2002 which compared the bone densities of women on Depo, to a group of women who had not used it. They found that women using Depo had a bone loss rate comparable to what occurs in menopause. The Depo users lost an average of 1.12% bone density at the hip per year of use, compared to only an average loss of 0.05% per year in non-users. In the spine, Depo users lost 0.87% per year, and the non-users actually gained density in their spine by 0.4% per year. Somewhat reassuring was the fact that within 2 1/2 years after stopping Depo, most users had bone densities close to the non-users. The exception group were the 18-21 year olds, who still had thinner bones after 2 1/2 years. We do not have the results of studies yet to see if they will ever regain their bone density.

For women who have osteopenia or osteoporosis, it is important that they discuss their options with their doctor. Certainly, I would not recommend further Depo use. To improve your bone strength, it is valuable to get regular, weight bearing exercise, such as walking, jogging, or aerobics. Sufficient calcium intake is important, usually at least three dairy servings a day, or calcium supplements if needed. Vitamin D will help with the absorption of the calcium, usually 200-600 International Units is recommended. Excessive alcohol use or smoking can also lead to osteoporosis, so these should be avoided.

Hopefully your bone density will recover over the next few years with proper care of your bone health. It will be important for you to have periodic evaluations to see if you need prescription medications in addition to the above measures to increase your bone strength. Again, I encourage you to explore the health benefits of learning natural family planning - I think you will find it very respectful of the dignity of women's health.

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