Medroxyprogesterone
A progestogen given as a 3-monthly contraceptive injection, and as tablets for abnormal uterine bleeding and with estrogen in HRT.
Also called medroxyprogesterone acetate (form used in medicines) or DMPA (abbreviation for the depot injection).
Drug card
- Class
- Progestogen
- How it works
- Activating progesterone receptors, so cervical mucus thickens against sperm
- Used for
- Contraception (depot injection)
- Endometriosis pain
- Abnormal uterine bleeding from hormonal imbalance
- Protecting the endometrium during estrogen HRT
- Known for
- Bone density loss, not always fully reversible
- Irregular bleeding, later often no periods
- Weight gain
- Its name
- -gest- means a progestogen
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does medroxyprogesterone work?
Medroxyprogesterone acetate activates progesterone receptors and turns proliferative endometrium secretory. As a depot injection it suppresses gonadotropin release, so follicles do not mature and ovulation stops, and it thickens cervical mucus; usual oral doses do not stop ovulation. The low estradiol it causes eases endometriosis pain but thins bone.
Like other progestogens: Progestogens bind progesterone receptors, nuclear receptors that switch on progesterone-responsive genes. They turn estrogen-primed endometrium from proliferative to secretory and thin it over time, thicken cervical mucus so sperm cannot pass, and at higher or depot doses suppress LH so ovulation stops. Given with estrogen in HRT they protect the endometrium.
Uses
What is medroxyprogesterone used for?
- Contraception (depot injection)
- Endometriosis pain
- Abnormal uterine bleeding from hormonal imbalance
- Protecting the endometrium during estrogen HRT
Side effects
Side effects of medroxyprogesterone
- Bone density loss, not always fully reversibleKnown forSerious
- Irregular bleeding, later often no periodsKnown for
- Weight gainKnown for
- Headache
- Pain, a lump or a dent where injected
- Mood changes and depression
- Delayed return of fertility, up to a year
- Blood clotsSerious
- Benign brain tumor (meningioma)Serious
- Slightly higher breast cancer riskSerious
- Severe allergic reaction (anaphylaxis)Serious
- Higher blood glucose in people with diabetes
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Not advised as contraception for more than 2 years unless other methods are unsuitable, because of bone loss.
- Contraindicated with thromboembolic disease, breast cancer, significant liver disease or undiagnosed vaginal bleeding.
- Stop it if a meningioma is diagnosed.
- After the last injection, fertility can take up to a year to return.
Good to know: Its long-acting depot form explains both its convenience and the slow return of fertility after stopping.
Remember it
A way to remember it
Progestogens plug and thin.
They plug the cervix with thick mucus and thin the lining of the uterus, which is why irregular or absent bleeding is the commonest complaint.
Written for biofideX
Its name
-gest- means progestogen
Covers progesterone and synthetic progestogens such as levonorgestrel, medroxyprogesterone and desogestrel. Norethisterone is a progestogen without it.
- Every drug name stem
Its class
Progestogens
Sources
Checked against
Written for biofideX in plain words, after checking these references:
- Medroxyprogesterone acetate injection (subcutaneous): label (DailyMed)
- Medroxyprogesterone acetate injection: label (DailyMed)
- Medroxyprogesterone acetate tablets: label (DailyMed)
- Medroxyprogesterone (NCI Thesaurus)
- Side effects and risks of the contraceptive injection (NHS)
- Medroxyprogesterone tablets (NHS)
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Reproductive and urinary health
Medroxyprogesterone is one of 9 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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