Provera (medroxyprogesterone acetate) is a hormonal medication taken orally as a tablet. It is recommended for treating numerous disorders involving imbalances of female hormones, such as heavy or non-existent menstrual cycles. Provera belongs to the family of medications known as progestins and is a synthetic version of the hormone progesterone, which is generated naturally after ovulation (when an egg is released from an ovary). It functions by restoring hormonal equilibrium and controlling ovulation.
Uses
The Therapeutic Goods Administration Australia (TGA) has authorised Provera to treat:
- Abnormal uterine bleeding, such as that caused by polycystic ovary syndrome (PCOS), is caused by hormonal imbalance and is unrelated to fibroid tumours or uterine cancer
- Endometrial hyperplasia (overgrowth of the uterine lining) may raise the risk of uterine cancer after menopause
Depo-Provera, an injectable version of medroxyprogesterone, is licensed as a contraceptive.
Not on the label
Provera is also used for the following conditions for which it has not obtained TGA approval:
- The heaviness of menstrual flow
- Abnormal periods
- Symptoms of menopause include hot flashes, vaginal dryness, and nocturnal sweats.
Provera is only accessible with a valid prescription. It is also offered in generic form.
Before Taking Provera
If you have been diagnosed with diseases that Provera cures, particularly if you cannot take oestrogen, your healthcare professional may prescribe you Provera. As part of the diagnostic and treatment procedure, your doctor will likely do a pelvic exam and may prescribe several tests, including testing for hormone levels, such as:
- Progesterone
- Oestrogens (estradiol, estriol, and estrone)
- Follicle-stimulating hormone (which stimulates the growth of eggs in the ovary)
- Testosterone and DHEA, male hormones
- Human thyroid hormones (thyroid-stimulating hormone, thyroxine, triiodothyronine)
- Human chorionic gonadotropin, the pregnancy hormone (HCG)
Among the imaging investigations utilised in the diagnosis procedure are:
- Ultrasound
- CT (computed tomography) scan
- Magnetic resonance imaging (MRI)
- Hysteroscopy (an examination of the uterus via a small camera inserted through the vagina)
- The particular tests your doctor prescribes depend on your symptoms and age (e.g., premenopausal or postmenopausal).
If you have never used oestrogens, your healthcare professional may initially prescribe them for specific circumstances if you have never taken them before. If you cannot take oestrogen supplements or if they are insufficiently effective, Provera may be substituted or added to your oestrogen regimen.
Discuss any medications, supplements, and vitamins you take with your doctor. Some medicines provide small interaction hazards, but others may be contraindicated or should be taken with care.
Only For Women Who Have a Uterus
If a hysterectomy has removed your uterus, you do not need progestin and will not be administered Provera or other medications in its class.
Cautionary Measures and Contraindications
Who should not use Provera? |
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Provera ingredients to inform the doctor about allergies |
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Things to inform the healthcare provider |
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Conditions requiring special monitoring |
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Other progestin medications available on the market are:
- Prometrium (micronised progesterone) is licensed to treat amenorrhea and, in conjunction with estrogens, to reduce menopausal symptoms.
- Minipill oral contraceptives containing norethindrone, including the brand names Errin, Heather, and Incassia.
Dosage
Provera is offered in three dose forms:
- 2.5 milligrams (mg) 5 mg 10 mg
- Healthcare professionals generally recommend the lowest effective dosage for the shortest duration feasible. The dose varies depending on the ailment being treated.
CONDITION DOSE DURATION TIMING NOTES
CONDITION | DOSE | DURATION | TIMING | NOTES |
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Amenorrhea | 5-10 mg/day | 5-10 days | N/A | Withdrawal haemorrhage 3-7 days after cessation of use |
Abnormal Uterine Haemorrhage | 5 to 10 mg daily | 5 to 10 days | Beginning on the sixteenth day of the menstrual cycle | Withdrawal haemorrhage 3-7 days after cessation of use |
Endometrial Hyperplasia | 5-10 mg/day | 12-14 days | Beginning on the first or sixteenth day of the menstrual cycle | Reevaluate the necessity for continuing treatment every three to six months. |
Endometriosis | 10 mg/day | Ten days | Beginning on the 16th day of menstruation | N/A |
Menopause Symptoms | 10-20 mg/day | N/A | N/A | N/A |
It is not permissible to determine dosages for off-label usage. Always follow your doctor’s directions while using prescription medications.
Modifications
If you have severe liver damage due to alcoholic cirrhosis, you should not use Provera. When prescribed, you may get a lesser dosage than the normal dose.
You may need to change your dose after beginning Provera if you use thyroid replacement hormone. In addition, your healthcare professional may recommend more regular blood tests to monitor your thyroid hormone levels.
How to Consume and Keep
Provera must be administered at certain times, so adhere to your healthcare provider’s recommendations. See your healthcare practitioner or pharmacist if you forget to start Provera on time, skip a dose, or have any concerns regarding dosage or schedule.
Provera has to be kept at room temperature.
Any postmenopausal woman with a uterus with vaginal bleeding should be checked to rule out malignancy.
Adverse Effects of Provera – Understanding the Risks
Provera, like many medications, can cause adverse effects in some individuals. It is important to be aware of this medication’s common and severe side effects.
Common side effects of Provera may include headaches, tender breasts, lactational milk secretion, irregular vaginal bleeding or spotting, acne, facial hair expansion, hair loss, insomnia, tiredness, nausea, PMS symptoms, or unintentional weight gain or loss. If these symptoms become severe, persist after taking the medication for a long time, or are a concern for you, you should contact your healthcare provider.
Other, less frequent adverse effects can be more serious and require immediate medical attention. This may include symptoms such as pain, edema, redness, and warmth in one leg; speaking difficulties or sluggish speech; vertigo or feeling faint; limb weakness or numbness; breathlessness, coughing up blood, sudden chest discomfort; a rapid or thumping heart rate; sudden vision changes or blindness; double or hazy eyesight; bulging eyes; skipped periods; depression; jaundice (yellow eyes and skin); fever; itchy rash; hives; itching; problems with breathing or swallowing; face, mouth, tongue, or neck enlargement; or edema in hands, feet, or lower legs. If you experience these symptoms, contacting your healthcare practitioner or seeking emergency medical treatment is important.
It is important to be aware of Provera’s potential adverse effects and seek medical attention if you experience severe symptoms.
If you combine Provera with oestrogen, you should also be cautious of oestrogen’s negative effects.
Interactions
Provera is not a contraceptive and will not prevent pregnancy when taken alone. Use another method of contraception, such as a condom, while taking this medication. Possible incompatibility between Provera and hormonal contraception.
When Provera is taken with estrogens, the TGA has mandated the inclusion of the following cautions on the packaging:
- Oestrogen and progestin should not be used to prevent cardiovascular disease or dementia.
- Oestrogen with progestin may raise the risk of heart attack, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis after menopause.
- Oestrogen with progestin may raise the risk of dementia beyond age 65. (It is uncertain whether this risk extends to those under 65.)
Provera may alter the outcome of the following laboratory tests:
- Thyroid hormone quantities
- Glucose tolerance
- Levels of cholesterol and triglycerides
- Hormone concentrations
- Binding proteins
- Interdrug Reactions
Provera should not be used with Cytadren (aminoglutethimide) or other CYP3A4 inducers/inhibitors since they may affect your body’s response to progestins.
Other substances may also be problematic. Ensure your healthcare practitioner knows everything you are taking, including over-the-counter medications and dietary supplements. Using the same pharmacy for all your prescriptions helps prevent adverse drug interactions.
Provera FAQs in Australia
What is the purpose of Provera?
Provera is used to treat abnormal periods or vaginal bleeding that is irregular. Prescribed to induce menstruation, lessen excessive bleeding, prevent uterine lining hyperplasia, and lower the risk of uterine cancer in oestrogen-treated females.
How long does Provera take to trigger menstruation?
Provera is used for up to 10 days during the second part of the menstrual cycle to treat amenorrhea. Your menstruation should begin three to seven days after your final Provera medication.
Is Provera 10 mg a contraceptive?
Although Provera is not a TGA-approved contraceptive, it is sometimes used off-label as birth control.
The injectable form of 2 Depo-Provera is used as a contraceptive.
Does Provera stop periods?
Provera is used to control and postpone menstrual cycles. You will not have a period while using Provera, but the bleeding will start a few days after you stop taking the medication.
Can Provera lead to weight gain?
Both weight gain and weight reduction are mentioned as potential Provera side effects.
What is the dosage of Provera for each condition it is used to treat?
The dosage of Provera for each condition it treats in Australia can vary depending on the specific condition and the severity of symptoms. Generally, Provera is taken in doses of 5-10 mg daily to treat amenorrhea and 10-20 mg per day for treating menopause symptoms. For endometrial hyperplasia, Provera is usually taken at 5-10 mg daily for 12-14 days, beginning on the first or sixteenth day of the menstrual cycle. For endometriosis, Provera is taken in a dose of 10 mg daily for ten days, beginning on the 16th day of menstruation. It is important to note that a healthcare professional should determine the appropriate dosage of Provera in Australia based on an individual’s specific medical history and needs.
Is there any evidence that taking Provera while trying to conceive affects fertility?
Limited evidence on the effects of taking Provera on fertility in Australia is available. Some studies have shown that taking Provera for extended periods may reduce fertility, while others have found no significant impact. It is important for individuals trying to conceive to discuss their use of Provera with a healthcare professional in Australia.
Are there any lifestyle changes recommended while taking Provera?
No specific lifestyle changes are required while taking Provera in Australia, although it is recommended to maintain a healthy diet and exercise routine. Additionally, individuals taking Provera should avoid smoking, which may increase the risk of certain side effects.
Can Provera be used in conjunction with other medications or treatments?
Provera can be used with other medications or treatments in Australia, although it is important to consult with a healthcare professional before combining Provera with other drugs. Certain medications may interact with Provera and cause unexpected side effects.
Are there any known side effects of long-term use of Provera?
Several known side effects of long-term use of Provera in Australia include changes in menstrual periods, tender breasts, and hair growth or skin quality. Additionally, long-term use of Provera has been associated with an increased risk of certain health conditions, including osteoporosis and heart disease. It is important for individuals considering long-term use of Provera in Australia to discuss this treatment’s potential risks and benefits with a healthcare professional.
Evan Kurzyp
Evan is the founder of Fertility2Family and is passionate about fertility education & providing affordable products to help people in their fertility journey. Evan is a qualified Registered Nurse and has expertise in guiding & managing patients through their fertility journeys.