What to Know About Provera (medroxyprogesterone acetate)

A hormonal treatment for heavy or missed periods

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Provera (medroxyprogesterone acetate) is a hormonal treatment taken by mouth in tablet form that may be prescribed for several conditions that include imbalances of female hormones, including heavy or absent menstrual periods. Provera is in a class of drugs called progestins and is a synthetic form of progesterone—a hormone naturally produced after ovulation (when an egg is released from an ovary). It works by correcting the hormonal balance and regulating ovulation.

Provera is available by prescription only. It's also available in generic form.

Depo Provera Side Effects

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Uses

Provera is approved by the Food and Drug Administration (FDA) to treat:

An injectable form of medroxyprogesterone called Depo-Provera is approved as birth control.

Off-Label Uses

Provera is also used for conditions that it hasn't received FDA approval for, including:

Before Taking

Your doctor may consider Provera for you if you're diagnosed with any of the conditions it treats, and especially if you can't take estrogen. As part of the diagnosis and treatment process, your doctor will likely perform a pelvic exam and may order numerous tests, including tests for levels of hormones including:

Imaging studies used in the diagnostic process may include:

The specific tests your doctor orders depend on your symptoms and stage of life (e.g., premenopausal or postmenopausal).

If you've never taken estrogens, you may be given them first for certain conditions and, if you don't tolerate them or they're not effective enough, you may be switched to Provera or have Provera added to your estrogen regimen.

Talk to your doctor about all medications, supplements, and vitamins that you currently take. While some drugs pose minor interaction risks, others may outright contraindicate use or prompt careful consideration as to whether the pros of treatment outweigh the cons in your case.

Only For Those With a Uterus

If you've had your uterus removed in a hysterectomy, you have no need for progestin and won't be prescribed Provera or other drugs in its class.

Precautions and Contraindications

Provera isn't safe for everyone. You shouldn't start taking it if you have:

  • Vaginal bleeding with an undiagnosed cause
  • Hormone-sensitive cancers (e.g., breast or uterine cancer) or a history of them
  • Had a stroke in the past year
  • Had a heart attack in the past year
  • Blood clots or a history of them
  • A bleeding disorder
  • Liver problems or a history of them
  • A possible or confirmed pregnancy
  • A known allergy to medroxyprogesterone or any ingredients in Provera

Inactive Ingredients in Provera

Tell your doctor if you're allergic to any of these Provera ingredients:

  • Calcium stearate
  • Corn starch
  • FD&C Yellow No. 6 (found only in the 2.5 milligram tablet)
  • Lactose
  • Mineral oil
  • Sorbic acid
  • Sucrose
  • Talc

Also, be sure to tell your doctor:

  • If you're planning to become pregnant
  • If you're breastfeeding
  • If you're planning to have surgery
  • If you have any other medical problems

These issues may affect whether you can take Provera, or if a break from the medication may be necessary (such as before surgery).

Conditions that may require closer monitoring while you're taking Provera include:

Other Progestins

Other progestin drugs on the market include:

  • Prometrium (micronized progesterone), which is approved for amenorrhea and, along with estrogens, reducing menopause symptoms
  • Oral contraceptives called the "minipill" that contain norethindrone, including brand names Camila, Errin, Heather, Incassia, and Jencycla

Dosage

Provera is available in three dosages:

  • 2.5 milligrams (mg)
  • 5 mg
  • 10 mg

Doctors typically prescribe the lowest effective dose and for the shortest amount of time possible. The dosage used varies by the condition being treated.

CONDITION DOSE DURATION  TIMING NOTES
Amenorrhea 5-10 mg/day 5-10 days N/A Withdrawal bleeding 3-7 days after discontinuing
Abnormal uterine bleeding 5-10 mg/day 5-10 days Starting the 16th day of the menstrual cycle Withdrawal bleeding 3-7 days after discontinuing
Endometrial hyperplasia 5-10 mg/day 12-14 days Starting the 1st or 16th day of the menstrual cycle Re-evaluate need for continued therapy every 3-6 months
Endometriosis 10 mg/day 10 days Starting 16th day of the menstrual cycle N/A
Menopause symptoms 10-20 mg/day As long as symptoms persist N/A N/A
Source: Prescribers' Digital Reference

Dosages may not be established for off-label uses. Always follow your doctor's instructions for prescription medications.

Modifications

Prescribing Provera for people with significant liver impairment from alcoholic cirrhosis is discouraged. If it is prescribed, the dosage may need to be lowered.

If you take thyroid replacement hormone, your dosage of that medication may need to be adjusted after you start Provera. Your doctor may want you to get more frequent lab work to check your thyroid hormone levels.

How to Take and Store

Because Provera has special timing requirements for most uses, be sure to follow your doctor's instructions for taking it. If you forget to start Provera when you're supposed to, if you miss a dose, or if you have any questions about dosage or timing, talk to your doctor or pharmacist for guidance.

Provera should be stored at room temperature (between 68 degrees and 77 degrees F).

Any vaginal bleeding in a postmenopausal woman with a uterus should be evaluated to rule out cancer.

Side Effects

As with any drug, Provera can cause side effects in some people. Some of these are common and not considered dangerous, while others are cause for calling your doctor right away.

Common

Common side effects of Provera don't require immediate medical care, but you should contact your doctor if any of these become severe, don't go away after you've been on the drug for a while, or are a significant problem for you:

  • Headaches
  • Tender breasts
  • Breast milk secretion
  • Irregular vaginal bleeding or spotting
  • Acne
  • Facial hair growth
  • Hair loss
  • Insomnia
  • Tiredness
  • Nausea
  • PMS symptoms
  • Unintended weight loss or gain

Severe

Other, less common side effects may be more serious. Call your doctor immediately or seek emergency medical attention if you experience:

  • Pain, swelling, redness, and warmth in one leg
  • Difficulty speaking or slow speech
  • Dizziness or feeling faint
  • Weakness or numbness in a limb
  • Shortness of breath
  • Coughing up blood
  • Sudden sharp or crushing chest pain
  • Fast or pounding heartbeat
  • Sudden vision changes or blindness
  • Double or blurred vision
  • Bulging eyes
  • Skipped periods
  • Depression
  • Jaundice (yellow eyes and skin)
  • Fever
  • Skin rash
  • Hives
  • Itching
  • Difficulty breathing or swallowing
  • Swollen face, mouth, tongue, or neck
  • Swollen hands, feet, or lower legs

If you take Provera with estrogen, be sure you're aware of the estrogen side effects, as well.

Warnings and Interactions

Provera by itself is not a contraceptive and won't prevent pregnancy. Use another form of birth control, such as a condom, while you're taking this drug. You may not be able to take Provera while also using hormonal birth control.

When Provera is combined with estrogens, the FDA has required that the following serious warnings be included with packaging information:

  • Estrogen and progestin should not be used to prevent heart disease or dementia.
  • After menopause, estrogen plus progestin may increase your risk of heart attack, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis.
  • After age 65, estrogen plus progestin may increase the risk of dementia. (It's unknown whether this risk applies to those under 65.)

Provera may interfere with the results of certain lab tests, including:

Drug Interactions

Provera shouldn't be taken with Cytadren (aminoglutethimide) or other CYP3A4 inducers/inhibitors, as they may alter the way your body responds to progestins.

Other drugs may pose problems as well. Be sure your doctor knows everything you're taking, including over-the-counter drugs and nutritional supplements. Using the same pharmacy for all of your prescription medications can help you avoid negative drug interactions.

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Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. U.S. Food and Drug Administration. Depo-Provera CI: Highlights of prescribing information.

  2. The American College of Obstetricians and Gynecologists. Progestin-only hormonal birth control: Pill and injection. Updated October 2020.

  3. National Institutes of Health, Eunice Kennedy Shriver National Institute of Child health and Human Development. What are the treatments for endometriosis? Updated February 21, 2020.

  4. American Cancer Society. Hormone therapy for endometrial cancer. Updated March 27, 2019.

  5. U.S. Food and Drug Administration. Menopause: Medicines to help you. Updated August 22, 2019.

  6. Thomas MP, Potter BV. The structural biology of oestrogen metabolismJ Steroid Biochem Mol Biol. 2013;137:27-49. doi:10.1016/j.jsbmb.2012.12.014

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