From the Guidelines
Women using Depo-Provera should take 1300 mg of calcium and 600 IU of vitamin D daily to support bone health, as recommended by the American College of Obstetricians and Gynecologists 1. This recommendation is based on the fact that Depo-Provera can reduce bone mineral density, particularly in the first 2-3 years of use.
Importance of Calcium and Vitamin D Supplementation
Calcium and vitamin D supplementation helps mitigate the effect of Depo-Provera on bone health by supporting bone density. The Society of Obstetricians and Gynaecologists of Canada (SOGC) recommends these supplements alongside weight-bearing exercise for all Depo-Provera users.
- The daily intake of 1300 mg of calcium and 600 IU of vitamin D is recommended for individuals between 9 and 18 years old 1.
- For individuals between 19 and 50 years old, the recommended daily intake is 1000 mg of calcium and 600 IU of vitamin D 1.
Considerations for Optimal Absorption
For optimal absorption, calcium supplements should be divided into doses of no more than 500 mg at a time, taken with food. Vitamin D can be taken at any time of day. Users should also be aware that bone density typically recovers after discontinuing Depo-Provera, and the contraceptive benefits of this method may outweigh the temporary bone density concerns for many women.
Monitoring Bone Health
Regular follow-up with a healthcare provider is recommended to monitor bone health if using Depo-Provera long-term. This allows for early detection of any potential issues and adjustment of supplementation as needed. By prioritizing bone health and following these recommendations, women using Depo-Provera can minimize the risk of bone density loss and maintain overall health.
From the Research
Vitamin D and Calcium Supplementation for Depo Provera Users
- The Canadian guidelines for vitamin D and calcium supplementation in Depo Provera users are not explicitly stated in the provided studies. However, a study published in The Journal of family practice 2 recommends that women using Depo Provera take 1300 mg of calcium and 400 IU of vitamin D.
Bone Mineral Density and Depo Provera Use
- Long-term use of Depo Provera has been associated with a decrease in bone mineral density (BMD) and an increased risk of osteoporosis 3.
- A study published in the Journal of pediatric and adolescent gynecology 4 found that most subjects on Depo Provera had normal BMD at first measurement, but low spinal BMD was associated with longer Depo Provera use.
- Another study published in the International journal of gynaecology and obstetrics 5 found that new users of Depo Provera experienced a 3.6% loss of lumbar spine BMD and a 2.1% loss of femoral neck BMD at 12 months.
Calcium and Vitamin D Metabolism
- A study published in the Annals of internal medicine 6 found that continuous low-dose hormone replacement therapy with conjugated equine estrogen and oral medroxyprogesterone, combined with adequate calcium and vitamin D, provides a bone-sparing effect in elderly women.
- The study published in the International journal of gynaecology and obstetrics 5 found that the Depo Provera group had higher phosphorus concentrations at 12 months compared to the IUD group.
Recommendations for Depo Provera Users
- Based on the study published in The Journal of family practice 2, women using Depo Provera should consider taking 1300 mg of calcium and 400 IU of vitamin D to support bone health.
- Additionally, Depo Provera users should be aware of the potential risk of decreased BMD and osteoporosis with long-term use, and discuss this risk with their healthcare provider 3.