Can vitamin D and calcium supplements be taken with medroxyprogesterone (Depo-Provera) for birth control to protect against osteoporosis with long-term use?

From the Guidelines

Yes, vitamin D and calcium supplements can be taken with medroxyprogesterone (Depo-Provera) and are actually recommended for women using this birth control method long-term. For women on Depo-Provera, experts suggest taking 1,000-1,200 mg of calcium daily along with 600-800 IU of vitamin D to help protect against bone density loss, as supported by the American College of Rheumatology guideline for the prevention and treatment of glucocorticoid-induced osteoporosis 1. This supplementation is particularly important because Depo-Provera can reduce estrogen levels, which may lead to decreased bone mineral density with prolonged use (especially beyond 2 years). The calcium and vitamin D work together to support bone health - calcium provides the building blocks for bone tissue, while vitamin D helps the body absorb and utilize calcium effectively. These supplements are safe to take alongside medroxyprogesterone and don't interfere with its contraceptive effectiveness. For best absorption, calcium supplements should be taken in divided doses throughout the day rather than all at once. Regular weight-bearing exercise is also recommended as an additional measure to help maintain bone strength while using this contraceptive method, as suggested by the management of osteoporosis in survivors of adult cancers with nonmetastatic disease: ASCO clinical practice guideline 1. It's essential to note that while the provided evidence primarily focuses on osteoporosis prevention in various contexts, the principles of calcium and vitamin D supplementation for bone health are applicable to women using Depo-Provera for birth control. However, the specific context of Depo-Provera use might require individualized consideration of bone health strategies, taking into account the potential effects of medroxyprogesterone on bone density. Given the importance of bone health and the potential for Depo-Provera to impact bone density, supplementation with calcium and vitamin D is a prudent measure to support overall health in women using this contraceptive method long-term.

From the Research

Vitamin D and Calcium Supplementation with Medroxyprogesterone

• Vitamin D and calcium supplements can be taken to protect against osteoporosis, as the combination of these two nutrients is effective in reducing the incidence of non-vertebral and hip fractures 2, 3.
• The recommended dosages for calcium and vitamin D supplements are at least 1200 mg and 800 IU per day, respectively, to achieve optimal efficacy 2, 3.
• Medroxyprogesterone (Depo-Provera) use has been associated with a decrease in bone mineral density (BMD), which may increase the risk of osteoporosis 4, 5.
• However, bone loss occurring with medroxyprogesterone use is reversible after discontinuation of the medication, and BMD values can return to baseline levels 4, 5.

Considerations for Long-Term Use

• Long-term use of medroxyprogesterone may require additional measures to protect against osteoporosis, such as vitamin D and calcium supplementation 2, 3.
• It is essential to monitor BMD regularly in women using medroxyprogesterone for extended periods to assess the risk of osteoporosis and adjust treatment plans accordingly 4, 5.
• The combination of calcium and vitamin D supplements can help mitigate the potential bone loss associated with medroxyprogesterone use, but individual results may vary 2, 3.