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Prolonged use of Depo Provera, a hormonal contraceptive that contains medroxyprogesterone acetate, has been associated with a reduction in bone density. This is particularly important to consider for women who may be using this form of contraception long-term, as decreased bone density can increase the risk of fractures and osteoporosis.

The mechanism behind the reduction in bone density is thought to be related to the effect of estrogen levels in the body. Depo Provera can lead to lower estrogen levels due to its continuous nature of hormone delivery, which can negatively impact bone mineralization and overall bone health.

While weight gain is a commonly reported side effect of Depo Provera, it is not the only concern, nor does it occur in all users. Claiming weight gain "only" overlooks the potential for other significant issues, including bone density reduction. Thus, stating that there are "no side effects" is misleading, as various side effects, including hormonal imbalances, can occur. Increased bone density is not an effect of prolonged exposure to this drug and contradicts existing research suggesting the opposite.