Bringing back your menses

Provera 2.5mg, 5mg and 10mg tablets
(medroxyprogesterone acetate)
Main use: Disorders of the menstrual cycle
Active ingredient: Medroxyprogesterone acetate
Manufacturer: Pfizer
How does it work?
Provera 2.5mg, 5mg and 10mg tablets contain the active
ingredient medroxyprogesterone acetate, which is a
synthetic form of the naturally occurring female sex
hormone, progesterone. It is used to treat various disorders
of the menstrual cycle.
A woman's menstrual cycle is a complex process that is
controlled by at least four different hormones. The blood
levels of these hormones change throughout the menstrual
cycle, causing an egg to be released from the ovaries
(ovulation), preparation of the womb lining for a possible
pregnancy and shedding of the womb lining each month if
pregnancy doesn't occur (a menstrual period). There are
plenty of places that this complex process can go wrong.
If your periods are irregular or have stopped completely and
your doctor can find no obvious cause, it may be that
something has upset your natural hormone levels.
Medroxyprogesterone can help to restore your natural
hormone levels, because it mimics the effects of your
natural progesterone.
Normally the level of progesterone in your blood increases
about a week before your period. If medroxyprogesterone is
taken for 5 to 10 days each month at this time (ie day 16 to
21 of your cycle) it mimics the natural rise in your
progesterone levels. This can help your other hormones to
behave in a more normal way. To treat irregular periods this
medicine is taken in this way for two menstrual cycles. To
treat periods that have stopped it is taken for three
menstrual cycles. In each case, a few days after you stop
taking the tablets you should get your period. At the end of
the treatment regular periods should return.
Endometriosis can also be treated by manipulating your
hormones with medroxyprogesterone. In this condition,
tissue resembling the womb lining grows abnormally around
the ovaries, womb and bladder. This tissue is controlled by
the same hormones that control your menstrual cycle, and
thickens and is shed in the same way as your normal womb
lining. Medroxyprogesterone is taken three times a day for
90 days, starting on the first day of your period, to control
this. The medroxyprogesterone stops the abnormal tissue
from thickening and then bleeding. As a result your
menstrual periods are also likely to stop during the
treatment as well; alternatively you might get irregular
bleeding or spotting. After treatment has finished the
patches of endometrial tissue may be smaller, or may have
shrunk away altogether.
What is it used for?
Dysfunctional menstrual bleeding , for example heavy,
painful, irregular or very frequent periods.
Menstrual periods that have stopped (secondary
amenorrhoea) .
Mild to moderate endometriosis .
How do I take it?
Provera tablets should be taken as directed by your
doctor. The number of tablets to take and when to take
them will depend on the condition being treated. The
instructions should be printed on the label that your
pharmacist has put on the packet of tablets. If you are
unsure about anything ask your doctor or pharmacist
for advice.
The tablets can be taken either with or without food.
If you forget to take a dose at your usual time you
should take it as soon as you remember, unless it is
nearly time for your next dose. In this case just leave
out the missed dose and take your next dose as usual
when it is due. Don't take a double dose to make up for
a missed dose.
Warning!
This medicine should not be used during pregnancy. It
does not provide contraception against pregnancy,
because it doesn't stop you releasing an egg
(ovulation). You should use a non-hormonal method of
contraception such as condoms to avoid getting
pregnant while you are taking this medicine. Ask your
doctor for advice.
Stop taking this medicine and inform your doctor
immediately if you experience any of the following
symptoms during treatment: stabbing pains or swelling
in one leg; pain on breathing or coughing; coughing up
blood; breathlessness; sudden chest pain; sudden
numbness affecting one side or part of the body;
fainting; worsening of epilepsy; migraine or severe
headaches; visual disturbances; severe abdominal
complaints; increased blood pressure; itching of the
whole body; yellowing of the skin or eyes (jaundice); or
severe depression.
Not to be used in
Women with known, suspected or past history of breast
cancer or cancer of the reproductive organs.
Women with liver disease such as liver tumours, or a
history of liver disease when liver function has not
returned to normal.
Women with severe disease of the arteries , eg that has
caused angina or a heart attack .
Women with a blood clot in the leg or lungs
(thromboembolism, eg deep vein thrombosis or
pulmonary embolism ).
Women with abnormal vaginal bleeding (not related to
your period) where the cause is not known.
Women with rare hereditary blood disorders called
porphyrias.
Pregnancy .
Provera tablets contain lactose and sucrose and should
not be taken by women with rare hereditary problems of
galactose intolerance, the Lapp lactase deficiency or
glucose-galactose malabsorption.
This medicine should not be used if you are allergic to one
or any of its ingredients. Please inform your doctor or
pharmacist if you have previously experienced such an
allergy.
If you feel you have experienced an allergic reaction, stop
using this medicine and inform your doctor or pharmacist
immediately.
Use with caution in
Women with decreased kidney or liver function.
Women with epilepsy.
Women who suffer from asthma .
Women who suffer from migraines.
Women with heart failure .
Women with high blood pressure.
Women with diabetes .
Women with gallstones.
Women with a history of jaundice or itching during
pregnancy.
Long-term condition called systemic lupus
erythematosus (SLE).
Women with a history of or increased risk of blood clots
in the blood vessels (thromboembolism, eg deep vein
thrombosis or pulmonary embolism ).
Women with gene mutations that are associated with
breast cancer, eg BRCA1.
Women with a history of depression .
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or
breastfeeding . However, other medicines may be safely
used in pregnancy or breastfeeding providing the benefits to
the mother outweigh the risks to the unborn baby. Always
inform your doctor if you are pregnant or planning a
pregnancy, before using any medicine.
This medicine should not be used in pregnancy. It does
not provide contraception itself. You should use a non-
hormonal method of contraception such as condoms to
avoid getting pregnant while taking this medicine. Seek
medical advice from your doctor. Stop taking this
medicine and consult your doctor if you think you could
be pregnant while taking this medicine.
This medicine passes into breast milk. However, there
is no evidence to suggest that this has any harmful
effects on the nursing infant if the medicine is used by
breastfeeding mothers.
Side effects
Medicines and their possible side effects can affect
individual people in different ways. The following are some
of the side effects that are known to be associated with this
medicine. Just because a side effect is stated here, it does
not mean that all people using this medicine will experience
that or any side effect.
Breast tenderness.
Production of breast milk.
Bloating.
Fluid retention.
Weight change.
Feeling sick.
Indigestion.
Headache.
Dizziness.
Nervousness.
Depression.
Difficulty sleeping (insomnia ).
Tiredness.
Skin reactions such as rash and itch.
Acne .
Increased hair growth (hirsutism).
Hair loss (alopecia).
The side effects listed above may not include all of the side
effects reported by the medicine's manufacturer. For more
information about any other possible risks associated with
this medicine, please read the information provided with the
medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what
medicines you are already taking, including those bought
without a prescription and herbal medicines, before you
start treatment with this medicine. Similarly, check with
your doctor or pharmacist before taking any new medicines
while taking this one, to make sure that the combination is
safe .
The following medicines may increase the breakdown of
this medicine in the body, which could make it less
effective:
aprepitant
barbiturates
bosentan
carbamazepine
crizotinib
dabrafenib
efavirenz
eslicarbazepine
griseofulvin
modafinil
nelfinavir
nevirapine
oxcarbazepine
perampanel
phenobarbital
phenytoin
primidone
rifampicin
rifabutin
ritonavir
rufinamide
the herbal remedy St John's wort (Hypericum perforatum )
topiramate
vemurafenib .
Ulipristal (the active ingredient of the emergency
contraceptive Ellaone and the medicine for fibroids Esmya )
also has the potential to make this medicine less effective.
This medicine may oppose the blood sugar lowering effect
of medicines for diabetes . If you have diabetes you should
monitor your blood sugar and seek advice from your doctor
or pharmacist if your blood sugar control seems to be
altered after starting this medicine.
Other medicines containing the same active
ingredient
Climanor .
Depo-provera (contraceptive injection).
Sayana press (contraceptive injection).
Medroxyprogesterone is used at much higher doses to help
treat some cancers, particularly endometrial cancer.
Provera 100mg, 200mg or 400mg tablets are available for
this purpose.