Serious Warnings and Precautions
This loss of BMD is of particular concern during adolescence and early adulthood, a critical period of bone accretion. It is unknown if the use of DEPO-PROVERA during adolescence or early adulthood will reduce peak bone mass and increase the risk for osteoporotic fracture in later life. A study to assess effects of DEPO-PROVERA in adolescent females showed that its use was associated with significant decline in BMD from baseline, and that mean BMD loss at total hip and femoral neck did not fully recover by 60 months (240 weeks) post-treatment. Similarly, in adults, there was only partial recovery of mean BMD at total hip, femoral neck and lumbar spine towards baseline by 24 months post-treatment.
Women considering using DEPO-PROVERA should be advised about the concerns that Depo-Provera may increase risk of HIV acquisition, about the uncertainty over whether there is a causal relationship, and about how to minimize their risk of acquiring HIV.