Provera is a trusted prescription medication containing medroxyprogesterone acetate, a synthetic form of the natural hormone progesterone. It is widely utilized in gynecological and endocrine practice to address a range of conditions stemming from hormonal imbalance. This progestin therapy offers a targeted approach to managing abnormal uterine bleeding, amenorrhea, and providing endometrial protection during estrogen replacement therapy. Its established efficacy and well-documented safety profile make it a cornerstone in therapeutic regimens for numerous patients.

Features

• Contains medroxyprogesterone acetate, a synthetic progestin.
• Available in multiple tablet strengths for tailored dosing (2.5 mg, 5 mg, and 10 mg).
• Oral administration for systemic effect.
• Mimics the action of natural progesterone in the body.
• Standardized formulation ensuring consistent potency and bioavailability.

Benefits

• Effectively stops abnormal uterine bleeding by stabilizing the endometrial lining.
• Induces regular menstrual cycles in women with secondary amenorrhea.
• Provides crucial protection against endometrial hyperplasia (a precursor to cancer) in postmenopausal women undergoing estrogen therapy.
• Offers a reliable and predictable hormonal response for treatment planning.
• Helps manage symptoms associated with progesterone deficiency.

Common use

Provera is primarily prescribed for the treatment of secondary amenorrhea (the absence of menstrual periods in women who have previously had a period) and abnormal uterine bleeding due to hormonal imbalance in the absence of organic pathology. Its other principal use is as part of menopausal hormone therapy (MHT), where it is combined with estrogen to protect the uterine lining from overgrowth, a condition known as endometrial hyperplasia. It is not intended for use as a contraceptive.

Dosage and direction

Dosage is highly individualized and must be determined by a healthcare professional based on the specific condition being treated. It is typically administered orally.

• Secondary Amenorrhea: 5 to 10 mg daily for 5 to 10 days. Withdrawal bleeding usually occurs within 3 to 7 days after discontinuing therapy.
• Abnormal Uterine Bleeding: 5 to 10 mg daily for 5 to 10 days, beginning on day 16 of the cycle. A prompt cessation of bleeding should occur. To produce a normal, cyclic, predictable bleeding pattern, dosing is often repeated for two more cycles.
• Endometrial Protection with Estrogen: When prescribed with conjugated estrogens, a common regimen is 10 mg of Provera daily for the last 12 to 14 days of each estrogen cycle.

The tablets should be taken with a full glass of water, with or without food, but consistency in timing is recommended. It is critical to follow the prescribed cyclic administration schedule exactly as directed by a physician.

Precautions

Before initiating therapy with Provera, a complete medical and family history should be taken. A physical exam should be performed with special attention to the breasts and pelvic organs, including a Pap smear. Patients should be monitored for signs of thrombotic disorders. Use with caution in patients with conditions that might be influenced by fluid retention, such as asthma, epilepsy, migraine, and cardiac or renal dysfunction. Provera may cause some degree of fluid retention; therefore, it should be used with caution in patients with a history of depression. Diabetic patients should be closely observed, as progestins can decrease glucose tolerance. Long-term use may lead to decreased bone mineral density.

Contraindications

Provera is contraindicated in patients with any of the following conditions:

• Known or suspected pregnancy.
• Known hypersensitivity to medroxyprogesterone acetate or any component of the formulation.
• Known or suspected carcinoma of the breast.
• Active deep vein thrombosis, pulmonary embolism, or a history of these conditions.
• Active or recent (within the past year) arterial thromboembolic disease (e.g., stroke, myocardial infarction).
• Undiagnosed abnormal genital bleeding.
• Known liver dysfunction or disease.
• Missed abortion.

Possible side effect

As with all medications, Provera can cause side effects, although not everybody gets them. Common side effects may include:

• Breast tenderness or pain
• Dizziness
• Headache
• Bloating, abdominal pain or cramping
• Nausea
• Fatigue
• Insomnia
• Acne
• Changes in weight
• Changes in menstrual flow or spotting/breakthrough bleeding
• Changes in libido

Less common but more serious side effects require immediate medical attention and can include:

• Sudden severe headache, vomiting, dizziness, or fainting (possible signs of a stroke or blood clot)
• Problems with vision or speech
• Weakness or numbness in a limb
• Severe chest pain or shortness of breath (possible signs of a pulmonary embolism or heart attack)
• Severe abdominal pain
• Jaundice (yellowing of the skin or eyes)
• Severe depression
• Lumps in the breast

Drug interaction

Provera may interact with other medications, which can alter its effectiveness or increase the risk of serious side effects. Inform your doctor about all medicines you are taking, including prescription, over-the-counter, and herbal products. Key interactions include:

• Aminoglutethimide: May significantly decrease the plasma levels and effectiveness of medroxyprogesterone.
• Enzyme-inducing drugs: Medications such as rifampin, rifabutin, phenobarbital, phenytoin, and carbamazepine can increase the metabolism of Provera, reducing its plasma concentration and clinical efficacy.
• Anticoagulants (Warfarin): Progestins can potentially increase or decrease the anticoagulant effect; close monitoring of prothrombin time is essential.

Missed dose

If a dose is missed, it should be taken as soon as remembered, unless it is almost time for the next dose. In that case, skip the missed dose and resume the usual dosing schedule. Do not take a double dose to make up for a forgotten one. Maintaining the prescribed cyclic schedule is critical for the drug’s effectiveness, particularly for endometrial protection. Consult the prescribing physician or pharmacist for specific guidance based on your treatment regimen.

Overdose

There have been no reports of serious ill effects from acute overdose. Overdose may cause nausea, vomiting, and possibly withdrawal bleeding in women. As medroxyprogesterone acetate is metabolized in the liver, overdose should be treated with general supportive measures. There is no known specific antidote. Medical attention should be sought if a large overdose is suspected.

Storage

Store Provera tablets at room temperature (20°C to 25°C or 68°F to 77°F), in a dry place, protected from light and moisture. Keep the medication in its original container, tightly closed, and out of reach of children and pets. Do not store in the bathroom. Properly discard any medication that is outdated or no longer needed.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The content has been compiled from various resources but may not be comprehensive or reflect the most recent medical information.

Reviews

“Provera was prescribed to regulate my cycles after months of amenorrhea. It worked exactly as my gynecologist described. The process was straightforward, and it successfully induced a period, which was a great relief.” – Patient A, treated for secondary amenorrhea.

“As part of my HRT, I take Provera for two weeks each month. My doctor explained its critical role in protecting my uterine health from the estrogen I also take. I’ve had no issues with it and feel confident that my regimen is safe and effective.” – Patient B, on combination hormone therapy.

“While effective for stopping prolonged bleeding, I did experience some bloating and breast tenderness during the 10-day course. The side effects subsided quickly after I finished the medication, and the primary issue was resolved.” – Patient C, treated for abnormal uterine bleeding.