Can I take medroxyprogesterone (MP) 20 mg short term to stop vaginal bleeding?

Medroxyprogesterone for Vaginal Bleeding

Medroxyprogesterone acetate 20 mg can be effectively used short-term to stop acute vaginal bleeding, typically administered every 8 hours for 3 days. 1

Dosing and Administration

For abnormal uterine bleeding, medroxyprogesterone acetate can be administered as follows:

• Acute bleeding episodes:

  • 20 mg orally every 8 hours for 3 days 1
  • May be combined with depot medroxyprogesterone acetate 150 mg intramuscularly for enhanced effectiveness 1

• For less acute bleeding:

  • 5 to 10 mg daily for 5 to 10 days 2, 3
  • The lowest effective dose should be used, with regular evaluation every 3-6 months 2

Efficacy and Timeframe

Research shows that medroxyprogesterone is effective for controlling vaginal bleeding:

• Mean time to bleeding cessation is approximately 2.6 days 1
• All women in a pilot study stopped bleeding within 5 days of treatment 1
• Side effects are typically infrequent with short-term use 1

Important Considerations

Before starting treatment:

• Medical history assessment: Medroxyprogesterone should be used cautiously in patients with certain conditions including:

  • Asthma
  • Epilepsy
  • Diabetes
  • Migraine
  • Endometriosis
  • Heart, liver, thyroid, or kidney problems 2

• Pregnancy status: Medroxyprogesterone should not be used as a pregnancy test 2

• Medication interactions: Inform healthcare provider about all medications being taken, as interactions may occur 2

Potential Side Effects

Common side effects of medroxyprogesterone include:

• Breast tenderness
• Breakthrough bleeding or spotting
• Irregular periods
• Headaches
• Nervousness or dizziness
• Depression
• Fatigue or sleepiness 2

More serious but less common side effects requiring immediate medical attention:

• Hives
• Breathing problems
• Swelling of face, mouth, tongue, or neck
• Severe chest pain or leg pain
• Sudden severe headaches
• Vision or speech changes 2

Follow-up Recommendations

• Regular follow-up is recommended to address any persistent adverse effects or adherence issues 4
• Assessment of response to treatment should occur after 3 months 4
• For long-term management of recurrent bleeding, alternative options may need to be considered

Alternative Options

If medroxyprogesterone is not effective or appropriate, other options include:

• Tranexamic acid
• Levonorgestrel-releasing intrauterine system (LNG-IUS)
• Combined hormonal contraceptives 4, 5

For women with von Willebrand disease, the LNG-IUD is recommended due to its better safety profile and reduced risk of bleeding complications 4.