From the Guidelines
Medroxyprogesterone acetate should be used with caution due to its potential side effects, including weight gain, bone mineral density loss, and menstrual irregularities, but it remains a highly effective contraceptive option with a typical failure rate of approximately 6% 1.
Overview of Medroxyprogesterone Acetate
Medroxyprogesterone acetate is a synthetic form of progesterone commonly used for several medical purposes, including hormone replacement therapy, treatment of abnormal uterine bleeding, contraception (Depo-Provera), and management of endometriosis or amenorrhea.
Dosage and Administration
As a contraceptive injection (Depo-Provera), it's administered as 150 mg intramuscularly every three months 2. For abnormal uterine bleeding, doses range from 5-10 mg daily for 5-10 days.
Side Effects and Precautions
Common side effects include weight gain, breast tenderness, headaches, mood changes, and irregular bleeding 2. The medication works by mimicking natural progesterone, regulating the menstrual cycle, preventing ovulation, and stabilizing the endometrial lining.
Important Considerations
It should be used with caution in patients with cardiovascular disease risk factors, liver disease, or history of depression 1. Regular follow-up appointments are important to monitor for side effects and evaluate treatment effectiveness.
Key Points to Consider
- Medroxyprogesterone acetate is a highly effective contraceptive option with a typical failure rate of approximately 6% 1
- It can cause weight gain, bone mineral density loss, and menstrual irregularities 2, 3
- Patients should be counseled about age-appropriate recommendations for supplementation with calcium and vitamin D and regular weight-bearing exercise to maintain skeletal health 3
- The effects of concomitant use of DMPA and tenofovir disoproxil fumarate on adolescent bone health are not known 3
From the FDA Drug Label
Medroxyprogesterone Acetate Injectable Suspension, USP is indicated only for the prevention of pregnancy The effectiveness of Medroxyprogesterone Acetate Injectable Suspension, USP is dependent on the patient returning every 3 months (13 weeks) for reinjection Medroxyprogesterone Acetate Injectable Suspension, USP, when administered at the recommended dose to women every 3 months, inhibits the secretion of gonadotropins which, in turn, prevents follicular maturation and ovulation and results in endometrial thinning.
The primary use of Medroxyprogesterone is for the prevention of pregnancy. It is a long-term injectable contraceptive that is effective when administered every 3 months. The medication works by inhibiting the secretion of gonadotropins, preventing follicular maturation and ovulation, and resulting in endometrial thinning. Key points about Medroxyprogesterone use include:
- Contraceptive effect: dependent on patient returning every 3 months for reinjection
- Mechanism of action: inhibits gonadotropin secretion, preventing ovulation and endometrial thinning
- Administration: recommended dose every 3 months 4, 5, 6
From the Research
Medroxyprogestterone Use
- Medroxyprogestterone acetate (MPA) is used in various contraceptive methods, including depot medroxyprogesterone acetate (DMPA) 7.
- The use of DMPA has been associated with reduced bone mineral density, leading to concerns about long-term fracture risk, particularly in adolescent and perimenopausal users 7.
- MPA is also used in combination with estrogen for hormone replacement therapy in postmenopausal women, and has been shown to increase bone mineral density and prevent osteoporosis 8.
- In the management of endometriosis, oral MPA has been found to be effective in improving or inducing remission of symptoms, and may also improve fertility outcomes 9.
- Common side effects of DMPA use include spotting, breakthrough bleeding, and amenorrhea, which can be managed with appropriate counseling and clinical evaluation 10.
- The use of progestogens, including MPA, in menopausal hormone therapy has been found to have both benefits and risks, including endometrial protection, but also increased breast cancer risk and diminished estrogen-induced benefits 11.