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In 2004, the FDA required that a black box warning be added to the labeling for depot medroxyprogesterone acetate contraceptive injection (DMPA [Depo-Provera]) regarding declines in BMD during DMPA use. The warning raised concerns among women and clinicians about the safety of this highly effective and convenient long-acting contraceptive. Progestin-only injectable contraceptives (DMPA and norethisterone [norethindrone] enanthate [NET-EN; not available in the U.S.]) are commonly used, often for many years, by South African women. In a large, cross-sectional, NIH-funded study, investigators assessed calcaneal (heel) bone thickness by ultrasound in approximately 3500 black and mixed-race South African women (age range, 18–44) who provided det…