Depot medroxyprogesterone acetate (DMPA) is known to potentially cause a reversible decrease in bone mineral density (BMD), leading to recommendations to consider cautionary use in some at-risk groups.1 However, there is no evidence that reversible loss of BMD leads to fragility fractures in premenopausal women. No studies have determined whether there is an increased fracture risk from use of DMPA.1

Lanza et al. have conducted a retrospective cohort analysis to determine whether there is a relationship between DMPA use and fracture risk, and …