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The reduction in BMD seen in long-term users of depot medroxyprogesterone acetate (DMPA) has been attributed to decreased ovarian estradiol production. To investigate this postulate, investigators recruited premenopausal women who had used DMPA for at least 2 years and who had below-average baseline lumbar-spine BMD. Women were excluded if they had metabolic bone diseases or elevated follicle-stimulating-hormone levels or if they were taking drugs that affect BMD.
Thirty-eight women who were matched for demographics, BMD, and biochemical variables were randomly assigned to receive 0.625 mg/day of conjugated estrogen (Premarin) or placebo; 26 completed the 2-year study. At 6-month intervals, participants were questioned about adverse events, …