Medroxyprogesterone Acetate (MPA) is a type of long-acting progestin which mimics the action of the natural hormone progesterone. Women who have not had a hysterectomy (a procedure to remove all or part of the uterus), or do not have a progesterone supplement in place, such as an intrauterine device (IUD), will need to take both oestrogen and progesterone supplements as part of their HRT. Progesterone supplements counteract the thickening effect of oestrogen supplements on the uterine lining, which can lead to endometrial cancer, endometriosis (growth of the womb lining outside of the womb) or endometrial hyperplasia (excessive thickening of the womb lining).
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Medroxyprogesterone Acetate (MPA) is a supplement for the hormone progesterone. MPA is used in hormone replacement therapy (HRT) to help treat the symptoms of menopause in women.
Other uses of MPA include treatment of abnormal uterine bleeding, amenorrhea (the absence of menstruation) in women who are not menopausal, and some types of cancer. MPA may also be injected as a form of birth control.
When women approach menopause, the level of oestrogen produced by the ovaries declines, resulting in symptoms such as hot flushes and night sweats, irregular periods, mood swings and vaginal dryness. HRT works by subsidising the body’s natural hormones, restoring the hormonal balance and relieving symptoms. HRT may also be used to prevent the onset of osteoporosis (weakening of the bones) in post-menopausal women.
In the United States, MPA is also sold under the brand name Provera. Both contain Methoxyprogesterone Acetate as the active ingredient and work in the same way.
MPA begins to work as soon as you start taking it, although you may not notice the effects immediately. Patients generally see a reduction in menopause symptoms within a few weeks of starting treatment.
The active ingredient in MPA is medroxyprogesterone acetate.
The inactive ingredients in MPA are lactose monohydrate, sucrose, maize starch, liquid paraffin, calcium stearate, talc, and purified water. The 2.5 mg tablets also include the coloring sunset yellow (E110), and the 5 mg tablets also include the color FD & C Blue No. 2 Aluminium Lake.
Different brands of MPA may include slightly different ingredients. Always check the ingredients listen on the pack before taking your medication.
The usual dose of MPA is 5 to 10 mg taken once daily for the first 12 to 14 days of the menstrual cycle. Your doctor will be able to decide which dose is best for you.
Always take MPA as instructed by your doctor. For premenopausal women, MPA should be taken once daily for 14 days, beginning 7 days after the first day of bleeding. For postmenopausal women who no longer experience natural periods, MPA can be taken for any 14 consecutive days in a 28 day cycle. MPA should be taken in combination with an oestrogen supplement, which you should continue to take daily for the whole 28 day cycle. During the break from your MPA pills, you will experience what is known as a withdrawal bleed. Try and remember to take your tablet at around the same time each day, for example, each morning with breakfast.
If you miss a dose of MPA, take it as soon as you remember. However, if you remember when it is nearly time for your next dose, skip the missed one and carry on as normal. Never take a double dose to make up for a missed one.
Like all medications, MPA can cause side effects in some patients. If you experience any of the following rare but severe side effects, stop taking MPA and seek immediate medical assistance:
The following common side effects may affect up to 1 in every 10 patients:
Uncommon side effects, which may affect up to 1 in 100 patients, include:
The frequency of the following side effects is too low to be estimated from the available data:
Do NOT take MPA if:
Before taking MPA, tell your doctor and take particular care if you have any of the following medical problems:
Tell your doctor if you are taking or have recently taken any other medications, including those purchased without a prescription. In particular, the following medications may alter the effect of MPA if taken at the same time:
MPA can be used for birth control in the form of an injection, and for this use if sold under the brand names Depo-Provera and DeposubQ-Provera 104. It works by altering the hormone imbalance during the menstrual cycle; the role of progesterone in the menstrual cycle is to prepare the uterus lining for implantation of a fertilised egg, and a drop in progesterone levels signals ovulation (the release of an egg from the ovaries). Injecting MPA interferes with this process, keeping progesterone levels high and preventing ovulation. Progesterone supplements such as MPA also have a thickening effect on the mucus in the cervix, which prevents sperm reaching the uterus in the event that an egg is released.
Although MPA can be used as a form of contraception, it will not protect you from STIs. The only form of contraception that offers protection from STIs is condoms.
HRT is widely used and considered a safe and effective treatment. While hormone supplements do carry risks, and it is important to be aware of them, these risks are small and generally outweighed by the benefits. Speak to your doctor for advice before starting HRT and, to minimize the risk of health complications, inform them of any existing or past health problems you might have. While continuing with HRT, it is important to go for regular smear tests and breast cancer screenings.
MPA is used in HRT, which is widely considered the most effective treatment for managing the symptoms of menopause. By supplementing the body’s natural hormones, HRT relieves symptoms such as night sweats and hot flushes, mood swings, irregular periods and vaginal dryness. It can also be used for delaying the onset of osteoporosis in post-menopausal women.
Research suggests that use of HRT, including MPA, can significantly increase interest in sex in postmenopausal women. It relieves symptoms such as vaginal dryness and clitoral atrophy, and has been known to boost libido.
HRT is usually prescribed at the lowest dose for the shortest time needed, depending on the personal requirements of the patient, because the potential risks and side effects do increase with time and age. What's more, HRT does not prevent osteoporosis, is just delay’s its onset. When you come off HRT is a personal decision, and your doctor will discuss your options with you. Never stop taking or change your HRT without first consulting a doctor.
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