Strong risk factors | Moderate risk factors |
---|---|
History of >6 months secondary amenorrhoea particularly if associated with anorexia nervosa (not including breastfeeding) | Family history (particularly of maternal hip fracture) |
Smoking | |
Excessive alcohol intake (>21 units/week) | |
Low BMI <20 kg/m2 | |
Oral steroid use for >3 months | A sedentary lifestyle |
Previous low-impact fracture | One or more strong risk factors? Two or more moderate risk factors? Inform the client of a possible risk of osteoporosis if continuing with DMPA |
Certain medical conditions (e.g. malabsorption, thyroid disease, rheumatoid arthritis, chronic liver disease) | |
Prolonged immobility |
BMI, body mass index; DMPA, depot medroxyprogesterone acetate.