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Human Reproduction, Vol. 14, No. 10, 2499-2505, October 1999
© 1999 European Society of Human Reproduction and Embryology

Norplant® implants and progesterone vaginal rings do not affect maternal bone turnover and density during lactation and after weaning

S. Díaz1,3, M.V. Reyes1, A. Zepeda1, G.B. González2, J.M. López2, C. Campino2 and H.B. Croxatto1

1 Instituto Chileno de Medicina Reproductiva, Consultorio de Planificación Familiar, J.V. Lastarria 29, Depto. 101 and 2 Departamento de Endocrinología, Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile

Bone density and turnover was assessed in a longitudinal study of healthy lactating women who initiated use of Norplant® implants (NOR, n = 29), progesterone vaginal rings (PVR, n = 28) or Copper T 380A intrauterine devices (T-Cu, n = 51, control group) around day 60 postpartum. Bone density, serum calcium, phosphorus, alkaline phosphatases, parathyroid hormone (PTH), follicle stimulating hormone (FSH), oestradiol and prolactin, and urinary hydroxyproline and creatinine were measured at postpartum months 1 (PM1), and 12 (PM12) and 6 or 12 months after weaning; at month 6 postpartum (PM6) serum and urine tests alone were performed. Baseline characteristics and lactation performance were similar between groups. Biochemical markers of bone turnover were higher at PM1, PM6 and PM12 than after weaning, with no differences between groups. Bone density in the lumbar spine (L2–L4) and femoral neck at PM1 and PM12 (~1.11 g/cm2) was similar in three groups. Lumbar spine values were found to be lower in lactating women than those present in non-lactating women, but increased after weaning to similar values. The two progestin-only contraceptives studied appear to have no deleterious effect upon bone density and metabolism in healthy lactating women.

Key words: bone density/bone metabolism/lactation/Norplant® implants/progesterone rings

3 To whom correspondence should be addressed at: Instituto Chileno de Medicina Reproductiva, José Ramón Gutiérrez 295, Depto. 3, Santiago, Chile


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