Provera is used for treating certain menstrual problems or uterine problems (e.g., abnormal bleeding, endometrial hyperplasia). It may also be used for other conditions as determined by your doctor.
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The mechanism of action of progestogen-only contraceptives depends
on the progestogen activity and dose. High-dose progestogen-only
contraceptives, such as injectable DMPA, inhibit follicular development
and prevent ovulation as their primary mechanism of action. The
progestogen decreases the pulse frequency of gonadotropin-releasing
hormone (GnRH) release by the hypothalamus, which decreases the
release of follicle-stimulating hormone (FSH) and luteinizing hormone
(LH) by the anterior pituitary. Decreased levels of FSH inhibit
follicular development, preventing an increase in estradiol levels.
Progestogen negative feedback and the lack of estrogen positive
feedback on LH release prevent a LH surge. Inhibition of follicular
development and the absence of a LH surge prevent ovulation.A secondary
mechanism of action of all progestogen-containing contraceptives
is inhibition of sperm penetration by changes in the cervical mucus.
Inhibition of ovarian function during DMPA use causes the endometrium
to become thin and atrophic. These changes in the endometrium could,
theoretically, prevent implantation. However, because DMPA is highly
effective in inhibiting ovulation and sperm penetration, the possibility
of fertilization is negligible. No available data support prevention
of implantation as a mechanism of action of DMPA.
Use Provera as directed by your doctor.
Take Provera by mouth with or without food.
Take Provera at the same time every day, with doses not more than 24 hours apart.
Ask your health care provider any questions you may have about how to use Provera.
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In the largest clinical trial of Depo-Provera, the most frequently
reported adverse reactions (which may or may not be related to the
use of Depo-Provera) were: menstrual irregularities (bleeding or
amenorrhea or both), abdominal pain or discomfort, weight changes,
headache, asthenia (weakness or fatigue), and nervousness. Other,
less frequently reported adverse reactions are listed in the patient
and physician label information for Depo-Provera.
Depo-Provera may be used by breast-feeding mothers. Heavy bleeding is possible if given in the immediate postpartum time and is best delayed until six weeks after birth. It may be used within five days if not breast feeding. While a study showed "no significant difference in birth weights or incidence of birth defects" and "no significant alternation of immunity to infectious disease caused by breast milk containing DMPA", a subgroup of babies whose mothers started Depo-Provera at 2 days postpartum had a 75% higher incidence of doctor visits for infectious diseases during their first year of life
Overdosage of estrogen plus progestin therapy may cause nausea and vomiting, breast tenderness, dizziness, abdominal pain, drowsiness/fatigue and withdrawal bleeding may occur in women. Treatment of overdose consists of discontinuation of CE/MPA together with institution of appropriate symptomatic care.
Read this PATIENT INFORMATION before you start taking PROVERA and read the patient information each time you refill your PROVERA prescription. There may be new information. This information does not take the place of talking to your health care provider about your medical condition or your treatment.