Provera (medroxyprogesterone acetate) is a prescription medication that’s used to treat some causes of female hormone imbalance that lead to menstrual cycle disruptions.

Provera is a progestin, a synthetic form of the hormone progesterone that’s naturally produced in the body after ovulation. It works by correcting the hormonal balance and regulating ovulation, which may help with irregular, missing, or unusually heavy periods.

This article explains its uses, such as taking Provera for PCOS (polycystic ovary syndrome). It adds information about drug dosages and side effects, as well as reasons why some people should not take Provera.

Uses for Provera

Provera is approved by the Food and Drug Administration (FDA) to treat:

  • An abnormal absence of menstrual periods due to another condition (secondary amenorrhea)
  • Abnormal uterine bleeding, such as from PCOS, that’s due to hormonal imbalance and not associated with conditions such as fibroid tumors or uterine cancer
  • Endometrial hyperplasia (overgrowth of the uterine lining) after menopause, which can increase the risk of uterine cancer

Off-Label Uses

Provera is also used for conditions that it hasn’t received FDA approval for, including:

An injectable form of medroxyprogesterone called Depo-Provera is approved as birth control.

  • Heavy menstrual bleeding
  • Irregular menstrual periods
  • Birth control
  • Endometriosis
  • Endometrial cancer
  • Menopause-related symptoms such as hot flashes, night sweats, and vaginal dryness (used along with estrogen)

Before Taking Provera

Provera may be a treatment option for certain conditions, especially if you can’t take estrogen.

What Does Provera Do for PCOS?

Provera is used to treat menstrual cycle irregularities in people living with polycystic ovary syndrome. It regulates hormone activity to reset and restore regular periods. Treatment for PCOS is important because it’s a known risk factor for endometrial cancer.

As part of the diagnosis and treatment process, your healthcare provider will likely perform a pelvic exam and may order numerous tests.

You might haven tests for hormone levels, including:

  • Progesterone
  • Estrogens (estradiol, estriol, and estrone)
  • Follicle-stimulating hormone, which stimulates the growth of eggs in the ovary
  • The male hormones testosterone and DHEA
  • Thyroid hormones (thyroid-stimulating hormone, thyroxine, triiodothyronine)
  • The pregnancy hormone human chorionic gonadotropin (HCG)

Imaging studies used in the diagnostic process may include:

  • Ultrasound
  • Computerized tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Hysteroscopy, an examination of the uterus via a small camera inserted through the vagina

The specific tests your healthcare provider orders depend on your symptoms and stage of life (e.g., premenopausal or postmenopausal).

If you’ve never taken estrogens, your healthcare provider may prescribe it first for certain conditions. If you don’t tolerate estrogen or it’s not effective enough, you may be switched to Provera or have Provera added to your estrogen regimen.

Talk to your healthcare provider about all medications, supplements, and vitamins that you currently take. While some drugs pose minor interaction risks, others may outright contraindicate Provera use or should be used with caution.

Precautions and Contraindications

Provera isn’t safe for everyone. You shouldn’t start taking it if you have:

Only For Those With a Uterus

If you’ve had your uterus removed with a hysterectomy procedure, you have no need for progestin and won’t be prescribed Provera or other drugs in its class.

  • Vaginal bleeding with an undiagnosed cause
  • Hormone-sensitive cancers, like breast or uterine cancer (or a history of them)
  • Had a stroke in the past year
  • Had a heart attack in the past year
  • Blood clots or a history of them
  • A bleeding disorder
  • Liver problems or a history of them
  • A possible or confirmed pregnancy
  • A known allergy to medroxyprogesterone or any ingredients in Provera

Before taking Provera, be sure to tell your healthcare provider:

Inactive Ingredients in Provera

Tell your healthcare provider if you’re allergic to any of these Provera ingredients:

  • If you’re planning to become pregnantIf you’re breastfeedingIf you’re planning to have surgeryIf you have any other medical problems

These issues may affect whether you can take Provera or if a break from the medication may be necessary, such as before surgery.

Conditions that may require close monitoring while you’re taking Provera include:

  • Asthma
  • Diabetes
  • Endometriosis
  • Epilepsy
  • Heart problems
  • High blood calcium levels
  • Kidney problems
  • Liver problems
  • Lupus
  • Migraines
  • Thyroid disease

Other Progestins

Other progestin drugs on the market include:

  • Prometrium (micronized progesterone), which is approved for treating amenorrhea and, along with estrogens, for reducing menopause symptoms
  • Oral contraceptives called the “minipill” that contain norethindrone, including brand names Camila, Errin, Heather, Incassia, and Jencycla

Provera Dosage

Provera is available in three dosages:

  • 2.5 milligrams (mg)5 mg10 mg

Healthcare providers typically prescribe the lowest effective dose and for the shortest amount of time possible. The dosage used varies by the condition being treated.

Dosages may not be established for off-label uses. Always follow your healthcare provider’s instructions for prescription medications.

Modifications

If you have significant liver impairment from alcoholic cirrhosis, Provera is discouraged. If it is prescribed, your dosage may be lower than the standard dose.

If you take thyroid replacement hormone, your dosage of that medication may need to be adjusted after you start Provera. Also, your healthcare provider may want you to get more frequent lab work to check your thyroid hormone levels.

How to Take and Store

Provera has to be taken at certain times, so be sure to follow your healthcare provider’s instructions for taking it.

If you forget to start Provera when you’re supposed to, if you miss a dose, or if you have any questions about dosage or timing, talk to your healthcare provider or pharmacist for guidance.

Provera should be stored at room temperature (between 68 degrees and 77 degrees Fahrenheit).

Provera Side Effects

Provera can cause side effects in some people. Some of these are common and not considered dangerous, while others are cause for calling your healthcare provider right away.

Any vaginal bleeding in a postmenopausal female with a uterus should be evaluated to rule out cancer.

Common

Provera use may lead to common side effects that don’t require immediate medical care, but you should contact your healthcare provider if any of them become severe, don’t go away after you’ve been on the drug for a while, or are a significant problem for you.

These side effects include:

  • HeadachesTender breastsBreast milk secretionIrregular vaginal bleeding or spottingAcneFacial hair growthHair lossInsomniaTirednessNauseaPMS symptomsUnintended weight loss or gain

Severe

Other, less common side effects may be more serious. Call your healthcare provider immediately or seek emergency medical attention if you experience:

  • Pain, swelling, redness, and warmth in one leg
  • Difficulty speaking or slow speech
  • Dizziness or feeling faint
  • Weakness or numbness in a limb
  • Shortness of breath
  • Coughing up blood
  • Sudden sharp or crushing chest pain
  • Fast or pounding heartbeat
  • Sudden vision changes or blindness
  • Double or blurred vision
  • Bulging eyes
  • Skipped periods
  • Depression
  • Jaundice (yellow eyes and skin)
  • Fever
  • Skin rash
  • Hives
  • Itching
  • Difficulty swallowing
  • Swollen face, mouth, tongue, or neck
  • Swollen hands, feet, or lower legs

If you take Provera with estrogen, be sure you’re aware of the estrogen side effects, as well.

Warnings and Interactions

Provera by itself is not a contraceptive and won’t prevent pregnancy. Use another form of birth control, such as a condom, while you’re taking this drug. You may not be able to take Provera while also using hormonal birth control.

When Provera is combined with estrogens, the FDA has required that the following serious warnings be included with packaging information:

  • Estrogen and progestin should not be used to prevent heart disease or dementia.
  • After menopause, estrogen plus progestin may increase your risk of heart attack, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis.
  • After age 65, estrogen plus progestin may increase the risk of dementia. (It’s unknown whether this risk applies to those under 65.)

Provera may interfere with the results of certain lab tests, including:

  • Thyroid hormone levelsGlucose toleranceCholesterol and triglyceride levelsHormone concentrationsBinding proteins

Drug Interactions

Provera shouldn’t be taken with CYP3A4 inducers/inhibitors, as they may alter the way your body responds to progestins.

Other drugs may pose problems as well. Be sure your healthcare provider knows everything you’re taking, including over-the-counter drugs and nutritional supplements. Using the same pharmacy for all of your prescription medications can help you to avoid negative drug interactions.

A Word From Verywell

Provera may offer benefits in treating conditions like PCOS and regulating your menstrual cycle. It also may be used to treat other diseases, such as endometrial cancer. If taking Provera, be sure to do so as directed and watch for any symptoms or side effects.

Frequently Asked Questions

  • Is medroxyprogesterone a birth control pill?
  • No. It’s not the same thing as Depo-Provera, the injectable birth control drug. The oral drug Provera by itself is not a contraceptive. You’ll need to use another birth control method to avoid pregnancy. Keep in mind that Provera can’t always be taken along with hormonal birth control.
  • Learn More:
  • What Is Depo-Provera
  • How many days after Provera should I get my period?
  • When used to treat amenorrhea (missing periods), Provera is taken for up to 10 days during the second half of the planned menstrual cycle. Your period should start three to seven days after your last dose of Provera.
  • Learn More:
  • An Overview of Amenorrhea
  • Does Provera reset your cycle?
  • Provera is used to regulate periods and can also be used to delay periods. You will not have a period while taking Provera, however, bleeding will begin several days after you stop taking Provera.
  • Does Provera cause weight gain?
  • Both weight gain and weight loss are listed as possible side effects of Provera.

No. It’s not the same thing as Depo-Provera, the injectable birth control drug. The oral drug Provera by itself is not a contraceptive. You’ll need to use another birth control method to avoid pregnancy. Keep in mind that Provera can’t always be taken along with hormonal birth control.

When used to treat amenorrhea (missing periods), Provera is taken for up to 10 days during the second half of the planned menstrual cycle. Your period should start three to seven days after your last dose of Provera.

Provera is used to regulate periods and can also be used to delay periods. You will not have a period while taking Provera, however, bleeding will begin several days after you stop taking Provera.

Both weight gain and weight loss are listed as possible side effects of Provera.

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  • The American College of Obstetricians and Gynecologists. Progestin-only hormonal birth control: Pill and injection.

  • National Institutes of Health, Eunice Kennedy Shriver National Institute of Child health and Human Development. What are the treatments for endometriosis?

  • American Cancer Society. Hormone therapy for endometrial cancer.

  • U.S. Food and Drug Administration. Menopause: Medicines to help you.

  • Okamura Y, Saito F, Takaishi K, Motohara T, Honda R, Ohba T, et al. Polycystic ovary syndrome: early diagnosis and intervention are necessary for fertility preservation in young women with endometrial cancer under 35 years of age. Reprod Med Biol. 2016 Dec 5;16(1):67-71. doi:10.1002/rmb2.12012.

  • Thomas MP, Potter BV. The structural biology of oestrogen metabolism. J Steroid Biochem Mol Biol. 2013;137:27-49. doi:10.1016/j.jsbmb.2012.12.014

  • Planned Parenthood. Depo-Provera Birth Control Shot.

  • Prescribers’ Digital Reference: PDR. Medroxyprogesterone acetate - drug summary.

  • U.S. National Library of Medicine: MedlinePlus. Medroxyprogesterone.

  • U.S. Food and Drug Administration: FDA AccessData. Provera (medroxyprogesterone acetate tablets, USP).

By Nicole Galan, RN

Nicole Galan, RN, is a registered nurse and the author of “The Everything Fertility Book.”