In the February 2006 issue of Pediatrics new guidelines were issued for pediatricians on calcium intake, bone growth, and the prevention of future osteoporosis. These guideline stress that we must work to increase calcium intake, especially, as the AAP release citing the article notes, “…during adolescence, when the peak rate of bone mass growth occurs.” The American College of Pediatricians agrees.
However, we are puzzled, as this same publication, the official Journal of the American Academy of Pediatrics, has, in the recent past, encouraged pediatricians and others to prescribe Depo-Provera as a safe and effective contraceptive for these same adolescents. These two recommendations are at odds with each other since this contraceptive carries an FDA “Black Box” warning that Depo-Provera causes bone demineralization, not preventable by the simultaneous increase in calcium intake. Even more perplexing, the Journal fails to recommend continuous abstinence from sexual activity, an increasingly popular choice of adolescents as a “contraceptive” method. This option avoids any demineralizing or other adverse effects.
The American College of Pediatricians wants only the best for all the youth of our nation. Accordingly, we recommend both increased calcium intake and sexual abstinence, goals that are not inherently contradictory.