Depo-Provera's black box: time to reconsider?

      Currently, over 2 million U.S. women, including many in their teenage years, use injectable depot medroxyprogesterone acetate (DMPA, Depo-Provera) [
      • Mosher W.D.
      • Martinez G.M.
      • Chandra A.
      • Abma J.C.
      • Willson S.J.
      Use of contraception and use of family planning services in the United States, 1982���2002. Advance data from vital and health statistics; no 350.
      ]. However, the United States Food and Drug Administration's (FDA) recent regulatory action regarding DMPA and skeletal health makes it likely that there will be a sharp decline in the use of this effective, convenient birth control option. A review of available evidence regarding progestin use, estradiol levels and long-term skeletal health suggests that the FDA's recent additional labeling for DMPA is unnecessary and should be revised or rescinded.
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