Contraceptive jab safety advice

Experts say young girls should only receive the contraceptive jab if other methods are unsuitable or unacceptable because of concerns about bone loss.

The Medicines and Healthcare products Regulatory Agency has sent letters to doctors outlining the updated advice. It is known Depo-Provera reduces bone density, which is an osteoporosis risk factor. New data suggest teens going through growth spurts could be particularly at risk. The news comes only days after the Minister for Children Margaret Hodge was slammed by critics for suggesting contraceptive injections could be a way to curb teenage pregnancy rates. But a spokesman for the Department for Education and Skills said the government did not promote any one form of contraception over another. The Committee on Safety of Medicines reviewed the available data, which includes a recent study involving adolescents on Depo-Provera. It said: “There is now evidence that Depo-Provera causes a loss of bone mineral density in adolescents, at a time when bone mineral density is normally increasing. Bone density loss “For this reason it is possible that the effect of Depo- Provera in adolescents may be more significant than in adults.” Professor Gordon Duff, chairman of the CSM, said the advice was precautionary. “There is currently no evidence to say whether use of Depo-Provera at any age is associated with an increased risk of osteoporosis and fracture in later life, but this possibility should be considered when prescribing Depo-Provera,” he said. There is some evidence that bone density starts to recover when Depo-Provera is stopped, but the extent of recovery is currently unknown and may be related to duration of exposure, experts believe. Depo-Provera is a long-acting, requiring intra-muscular injections every 12 weeks, that contains a form of progesterone. The MHRA said there was no need for women on Depo-Provera to stop using it on the basis of its updated advice. “If any woman is concerned, she should discuss this with her healthcare professional,” said a spokesman. Depo-Provera accounts for less than 3% of all prescription contraceptives that are used in the UK. (Source: BBC Health, Nov 2004)