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 hormone levels in the body, helping to manage menstrual irregularities, prevent endometrial hyperplasia, and treat certain types of cancer. Its well-established efficacy and decades of clinical use make it a cornerstone in gynecological and oncological therapeutic regimens, offering a targeted approach to restoring hormonal balance and protecting health.

Features

• Active ingredient: Medroxyprogesterone Acetate
• Available in 2.5 mg, 5 mg, and 10 mg oral tablets
• Synthetic progestin with high bioavailability
• Multiple therapeutic indications
• Prescription-only medication

Benefits

• Regulates abnormal uterine bleeding and restores predictable menstrual cycles
• Reduces the risk of endometrial hyperplasia in postmenopausal women on estrogen therapy
• Provides secondary amenorrhea management, offering relief from absent menstrual periods
• Serves as a palliative treatment option for advanced endometrial or renal carcinoma
• Helps manage endometriosis-associated pain in certain cases
• Offers flexible dosing options tailored to individual therapeutic needs

Common use

Provera is commonly prescribed for treating secondary amenorrhea (absence of menstrual periods in women who previously had regular cycles) and abnormal uterine bleeding due to hormonal imbalance. It is widely used in combination with estrogen in hormone replacement therapy for postmenopausal women to protect the uterine lining from hyperplasia. Additionally, it is employed as a palliative treatment for advanced endometrial cancer and renal cell carcinoma. Some clinicians may prescribe it off-label for managing endometriosis symptoms 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: 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, with bleeding expected within 3-7 days after cessation. For endometrial hyperplasia prevention in women receiving conjugated estrogens: 5-10 mg daily for 12-14 consecutive days per month. For palliative cancer treatment: 400-1000 mg weekly, often administered intramuscularly. Always take exactly as prescribed, with or without food as directed, typically at the same time each day to maintain consistent hormone levels.

Precautions

Patients should undergo thorough medical evaluation before starting Provera, including breast examination and Pap smear. 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 monitor blood glucose levels closely as Provera may decrease glucose tolerance. Long-term use may decrease bone mineral density, particularly in young women with functional hypothalamic amenorrhea.

Contraindications

Provera is contraindicated in patients with known hypersensitivity to medroxyprogesterone acetate or any component of the formulation. It should not be used in women with known or suspected pregnancy, undiagnosed abnormal genital bleeding, known or suspected breast cancer, active thrombophlebitis, current or history of thromboembolic disorders, or cerebral vascular disease. It is contraindicated in patients with missed abortion, liver dysfunction or disease, and as a diagnostic test for pregnancy.

Possible side effect

Common side effects include nausea, bloating, breast tenderness, headaches, dizziness, drowsiness, fatigue, irregular bleeding, spotting, changes in menstrual flow, amenorrhea, and edema. Less frequently, patients may experience mood changes, depression, insomnia, acne, hirsutism, alopecia, changes in weight, reduced libido, hot flashes, and rash. Serious but rare side effects include thrombophlebitis, pulmonary embolism, retinal thrombosis, optic neuritis, and anaphylactic reactions. Any unusual symptoms should be reported immediately to a healthcare provider.

Drug interaction

Provera may interact with aminoglutethimide, potentially decreasing medroxyprogesterone levels. Anticonvulsants such as phenobarbital, phenytoin, and carbamazepine may increase metabolism of progestins, reducing their effectiveness. Protease inhibitors and other drugs that induce hepatic enzymes may alter Provera metabolism. Concurrent use with other hormonal contraceptives or hormone replacement therapies may require dosage adjustments. Monitor patients taking warfarin or other anticoagulants as progestins may affect coagulation parameters.

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed one. For patients on cyclic therapy, contact your healthcare provider for instructions if a dose is missed, as the timing may affect treatment efficacy. Consistent dosing is important for maintaining therapeutic hormone levels, particularly when used for cancer treatment or endometrial protection.

Overdose

No serious adverse effects have been reported following acute overdose with Provera. In cases of massive overdose, symptomatic treatment may be provided. Gastrointestinal symptoms such as nausea and vomiting might occur. There is no specific antidote; management should be supportive and symptomatic. Dialysis is not likely to be effective due to high protein binding. Contact poison control or seek emergency medical attention if overdose is suspected.

Storage

Store at controlled room temperature (20-25°C or 68-77°F), with excursions permitted between 15-30°C (59-86°F). Keep in the original container, tightly closed, and protect from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Properly discard any unused medication after treatment completion according to local guidelines for medication disposal.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Provera is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual results may vary, and not all patients will experience the same benefits or side effects. Always consult with your healthcare provider before starting or changing any medication regimen. The full prescribing information should be reviewed before initiation of therapy.

Reviews

Clinical studies and patient reports consistently demonstrate Provera’s effectiveness in managing menstrual disorders and providing endometrial protection. Many patients report significant improvement in bleeding patterns and symptom control. Some users note side effects such as weight changes and mood swings, though these often diminish with continued use. Healthcare providers appreciate its well-established safety profile and dosing flexibility. Overall satisfaction is high among appropriately selected patients, particularly when expectations are managed regarding potential side effects and treatment duration.