Provera (medroxyprogesterone acetate) is a prescription progestin medication used to treat a variety of hormone-related conditions in women. As a synthetic form of the natural hormone progesterone, it works by adjusting hormonal balance in the body, addressing issues from abnormal uterine bleeding to endometriosis. It is a well-established therapy with decades of clinical use, offering a targeted approach to managing reproductive health. This medication requires a healthcare provider’s prescription and supervision to ensure its appropriate and safe use.

Features

• Active ingredient: Medroxyprogesterone Acetate
• Available in 2.5 mg, 5 mg, and 10 mg oral tablets
• Synthetic progestin with high bioavailability
• FDA-approved for multiple gynecological and oncological indications
• Typically supplied in bottles of 30 or 100 tablets

Benefits

• Effectively treats abnormal uterine bleeding by regulating endometrial growth
• Provides reliable contraception when used as part of a combination hormone regimen
• Reduces endometrial hyperplasia risk in women receiving estrogen therapy
• Manages pain and symptoms associated with endometriosis
• Offers a well-tolerated hormonal treatment option with established safety data
• Helps restore regular menstrual cycles in women with amenorrhea

Common use

Provera is commonly prescribed for treating secondary amenorrhea (absence of menstrual periods in women who previously had regular periods), abnormal uterine bleeding due to hormonal imbalance, and as protection against endometrial hyperplasia in postmenopausal women receiving estrogen therapy. It is also used in combination with estrogen for hormone replacement therapy and occasionally for endometrial cancer treatment. Some healthcare providers may prescribe it off-label for managing endometriosis-related pain or for luteal phase support in fertility treatments, though these uses require careful medical supervision.

Dosage and direction

Dosage varies significantly based on the condition being treated. For secondary amenorrhea: typically 5-10 mg daily for 5-10 days, with withdrawal bleeding expected within 3-7 days after completion. For abnormal uterine bleeding: 5-10 mg daily for 5-10 days, beginning on day 16 of cycle if cycles are regular. For endometrial protection with estrogen therapy: 2.5-10 mg daily for 12-14 days per month in cyclical therapy or 2.5-5 mg daily in continuous combined therapy. Tablets should be taken at the same time each day, with or without food. Always follow the specific dosing instructions provided by your healthcare provider, as individual requirements may vary based on medical history and treatment response.

Precautions

Patients should undergo thorough medical evaluation before starting Provera, including breast examination and Pap smear if appropriate. Use with caution in patients with history of depression, as progestins may exacerbate symptoms. Monitor blood pressure regularly during treatment. Patients with conditions that may be influenced by fluid retention (such as epilepsy, migraine, asthma, or cardiac or renal dysfunction) require careful observation. Diabetic patients should be monitored closely as progestins may decrease glucose tolerance. Long-term use may decrease bone mineral density, particularly concerning for women with other osteoporosis risk factors.

Contraindications

Provera is contraindicated in patients with known hypersensitivity to medroxyprogesterone acetate or any component of the formulation; known or suspected pregnancy; undiagnosed abnormal genital bleeding; known or suspected breast cancer; active or history of deep vein thrombosis or pulmonary embolism; active or recent arterial thromboembolic disease; liver dysfunction or disease; and missed abortion. It should not be used by women who are breastfeeding.

Possible side effect

Common side effects (≥1%) include menstrual irregularities, amenorrhea, breast tenderness, weight changes, nausea, headache, dizziness, fatigue, and fluid retention. Less common but more serious side effects may include thrombophlebitis, pulmonary embolism, retinal thrombosis, cerebral thrombosis, depression, insomnia, allergic reactions, jaundice, and anaphylaxis. Some women may experience changes in libido, acne, hirsutism, alopecia, or changes in cervical erosion and secretions. Long-term use has been associated with a small increased risk of breast cancer, cardiovascular events, and osteoporosis.

Drug interaction

Provera may interact with aminoglutethimide, potentially decreasing progestin effectiveness. Barbiturates, carbamazepine, phenytoin, rifampin, and St. John’s wort may increase metabolism of medroxyprogesterone, reducing its efficacy. Progestins may affect glucose metabolism, potentially requiring adjustment of antidiabetic medications. Concurrent use with other hormonal therapies may have additive effects. Provera may interfere with laboratory tests including thyroid function tests, coagulation parameters, and metyrapone tests.

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not double the dose to make up for a missed one. For contraceptive use, follow specific instructions provided with combination hormone products, as missing doses may compromise effectiveness. Contact your healthcare provider for guidance if multiple doses are missed or if you’re unsure how to proceed, particularly when using Provera for cycle regulation or contraception.

Overdose

No serious adverse effects have been reported following acute overdose with Provera. In case of suspected overdose, symptomatic and supportive treatment should be provided. Because of the hormonal nature of the medication, monitoring for potential exaggerated pharmacological effects such as nausea, vomiting, drowsiness, or dizziness is recommended. There is no specific antidote for medroxyprogesterone acetate overdose. Dialysis is not expected to be effective due to the drug’s high protein binding and extensive distribution.

Storage

Store at room temperature (20-25°C or 68-77°F) in the original container, protected from light and moisture. Keep tightly closed and out of reach of children. Do not store in bathroom cabinets where humidity and temperature fluctuations may occur. Properly discard any expired or unused medication according to local regulations, typically through medication take-back programs rather than flushing down toilets or throwing in household trash.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Provera is a prescription medication that should only be used under the supervision of a qualified healthcare provider. Individual treatment plans must be developed based on comprehensive medical evaluation. Always consult with your healthcare provider for diagnosis, treatment recommendations, and monitoring appropriate for your specific medical situation. Do not start, stop, or change dosage without medical supervision.

Reviews

Clinical studies and patient reports generally indicate Provera is effective for its approved indications when used as directed. Many patients report successful regulation of menstrual cycles and improvement in abnormal bleeding patterns. Some users note side effects including weight gain and mood changes, while others tolerate the medication well. Healthcare providers often consider it a valuable option in their therapeutic arsenal for hormone-related conditions, particularly appreciating its established safety profile and predictable effects. Patient satisfaction often correlates with proper patient education and appropriate expectation management regarding potential side effects and treatment timeline.