About YOUR Health- Questions and Answers from the NWHN Women's Health Information Clearinghouse

Q: I'm thinking about getting Norplant or Depo-Provera. What questions should I ask my doctor?
A: The decision to begin taking a longacting contraceptive such as Norplant or Depo-Provera is one that should be considered carefully. It is important that you have access to accurate and unbiased information.

First, you may want to ask "What are Norplant and Depo-Provera?" You will also want to ask "How do they work?" It is important to ask about side effects. You should be able to obtain information about possible long term side effects as well as the short term ones. It is also important to ask about reversibility how soon after you stop taking the contraceptive will you be able to get pregnant. You should ask yourself if you are aware and informed about other birth control options. Ask your health care provider for more information if you need it. Make sure to ask if there are any women who should not take Norplant or Depo-Provera. If you are choosing Norplant, ask about removal. Is your health care provider trained in removing Norplant? Will it cost anything to get it removed? What happens if you move to another city or state?

Choosing long term contraception should be a personal, well informed decision. Make sure you feel satisfied with the information you are receiving and choose what is right for you.
For more information, contact the Information Clearinghouse to order the Norplant and Depo-Provera packets.

Q: I recently underwent bone density screening which resulted in a diagnosis of borderline osteoporosis. Now, my doctors are encouraging me to undergo drug treatment for my condition. Should I take their advice?
A: Osteoporosis is a condition of decreased bone mass linked to fractures and a disruption in the normal structural integrity of the skeleton. Currently, the World Health Organization defines osteoporosis as a value for bone miners density 2.5 standard deviations or more below the young adult mean, with bone density screening being the primary method of measurement. Being told that you are at risk of developing osteoporosis is neither a guarantee that you will develop osteoporosis in the future, nor that you will necessarily suffer disabling bone fractures; it is simply a measurement of bone density.

Based on the available data, the Network believes that the current definition is too broad, and may lead to overdiagnosis and treatment with drugs that lack long-term study. Drug treatment for osteoporosis, especially if begun around the time of menopause, must be continued for decades, which in the case of estrogen increases breast cancer risk. Fosamax (alendronate) is a nonhormonal drug that was approved for treatment of osteoporosis in postmenopausal women. Discontinuing Fosamax may result in loss of previously gained bone density, but testing in this area is incomplete. Evista (raloxifene) works as a "partial" estrogen, and in short term studies it appears to increase bone mass by 2%. As there is no certain information on the possible long term effects of these drugs, it is very important to consider drug therapy carefully, inform yourself completely and make the decision that is best for you. For all women, we advise taking simple steps to prevent bone loss and fracture: exercise, appropriate calcium intake, and avoidance of drugs and other chemicals which can lead to additional bone loss.
For more information, request our newly revised Osteoporosis Perspective.