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Hormonal therapies to reduce or stop menstrual bleeding have long been used to manage a number of gynecologic conditions including menstrual cramps (dysmenorrhea), heavy menstrual bleeding, irregular or other abnormal uterine bleeding, menstrual-related mood changes (premenstrual syndrome or premenstrual dysphoric disorder), and pelvic pain due to endometriosis or uterine fibroids.
Medroxyprogesterone acetate (MPA), also known as depot medroxyprogesterone acetate (DMPA) in injectable form and sold under the brand name Depo-Provera among others, is a hormonal medication of the progestin type. [10] [4] It is used as a method of birth control and as a part of menopausal hormone therapy.
Medroxyprogesterone, also known as 6α-methyl-17α-hydroxyprogesterone or as 6α-methyl-17α-hydroxypregn-4-en-3,20-dione, is a synthetic pregnane steroid and a derivative of progesterone. [ 2 ] [ 3 ] It is specifically a derivative of 17α-hydroxyprogesterone with a methyl group at the C6α position.
Medroxyprogesterone acetate (brand names Depo-Provera, Provera, Depo-subQ Provera 104) [4] – 150 mg (intramuscularly) or 104 mg (subcutaneously) every 3 months [3] Norethisterone enanthate (brand names NET EN, Noristerat, Norigest, Doryxas) [ 5 ] – 200 mg (intramuscularly) every 2 months [ 3 ]
Delay in starting the next packet of active pills (i.e., extending the pill-free, inactive pill or placebo pill period beyond 7 days), Intestinal malabsorption of active pills due to vomiting or diarrhea, Drug-drug interactions among COCPs and other medications of the user that decrease contraceptive estrogen and/or progestogen levels. [44]
[1] [6] [81] In contrast to depot medroxyprogesterone acetate, no increase in VTE risk has been observed with moderately high doses of the related progestin chlormadinone acetate (10 mg/day for 18–20 days/cycle), though based on limited data. [94] [95]
Medroxyprogesterone acetate (Amen, Curretab, Cycrin, Provera) – 2.5 mg, 5 mg, 10 mg; Megestrol acetate (Megace) – 20 mg, 40 mg – approved specifically for the treatment of breast and endometrial cancer [46] and for the treatment of anorexia, cachexia, and weight loss in patients with AIDS Tooltip acquired immunodeficiency syndrome [47]
Major examples of progestins include the 17α-hydroxyprogesterone derivative medroxyprogesterone acetate and the 19-nortestosterone derivative norethisterone. The progestins are structural analogues of progesterone and have progestogenic activity similarly, but differ from progesterone in their pharmacological properties in various ways. [5]
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