Provera

Provera is a medicine used in hormone replacement therapy (HRT) to help balance the body's hormone levels. It contains medroxyprogesterone acetate, which is a man-made version of the female hormone progesterone. Progesterone plays a key role in the female reproductive system, including regulating the menstrual cycle and getting the uterus ready for pregnancy.

In hormone replacement therapy, Provera is commonly given to women who have gone through menopause to safeguard the lining of the womb. It can be used alongside oestrogen to help ease menopause symptoms such as hot flushes, night sweats, vaginal dryness, low libido, and tiredness.

Provera contains medroxyprogesterone acetate, which is a type of medicine known as a progestogen. It acts like the female hormone progesterone. Once inside the cells, it binds to a specific receptor to do its job. During and after menopause, hormone levels drop, and Provera helps to make up for this. When you're on oestrogen as part of your HRT, it can cause the lining of the uterus to thicken, potentially raising the risk of womb cancer. Taking a progestogen like Provera helps to balance this effect and works alongside oestrogen to relieve menopause symptoms.

Provera comes in 2.5mg, 5mg, and 10mg tablets, which are used to treat menstrual problems, endometriosis, and menopause symptoms. There are also higher strengths of 100mg, 200mg, and 400mg, but these are typically prescribed for certain types of cancer.

As with all medicines, Provera can lead to side effects, although not everyone will experience them. Around one in ten people might have headaches, nausea, or irregular bleeding or spotting. Some common side effects include allergic reactions, so if you notice any, stop taking it and contact your clinician. Other possible effects are mood changes, trouble sleeping, anxiety, dizziness, hair loss, acne, itching, vaginal discharge, breast tenderness, and weight gain. If any of these worry you, speak to your clinician, who can adjust your dose or suggest a different treatment.

There are a few treatments that contain the same active ingredient as Provera. One of these is Depo-Provera, which is produced by the same company. Unlike Provera tablets, Depo-Provera is given as an injection. It's mainly used for contraception and provides protection for eight to thirteen weeks. Interestingly, a study explored using medroxyprogesterone acetate injections for menopause and found that 89.5% of participants experienced relief from symptoms, compared to just 25% in the control group. This suggests it could be a promising alternative for menopausal women in the future.

Other treatment options include combined HRT, which often contains medroxyprogesterone as one of its active ingredients. Depending on where you are in menopause, a continuous combined tablet might be more convenient, as it means you don't need to remember to take two separate tablets. Indivina, Premique, and Tridestra are examples of combined HRTs that use the same active ingredient as Provera, but they're produced by different companies, so their cost and packaging might vary.

Weight gain is a common side effect and may be more likely if you've been taking it for a long time. One study examined the connection between weight gain and medroxyprogesterone, finding that the medication can lead to an average weight increase of 2.40kg. This is particularly true for those who start using it at a young age for contraception.

While this might seem discouraging, it's worth noting that some patients might not notice any changes in their weight, or they might even lose weight. If you're interested in exploring a different type of progestogen, have a chat with your clinician.