Hello, Thanks for sharing your health concern with us. Bone loss or osteoporosis, is one long term side effect of hormone use. However, regular monitoring is needed to assess the hepatic function, coagulation profile, breast condition, cardiovascular function, uterine state and blood counts, since there is a systemic influence. If your patient needs to be transferred from depo shots, if she is fit to continue hormones, you can try an implant or other forms of topical applications, if oral pills are to be avoided. If hormones are to be avoided, barrier methods are to be used with double protection. Hope this helps.