Medroxyprogesterone endometriosis

Like the medical treatment of uterine leiomyomas, danazol, gestrinone, mifepristone, and GnRH-a, with or without add-back therapy, have been proposed for the treatment of endometriosis as well (Olive et al. 2001 Stones et al. 2004), but unlike leiomyomas, oral contraceptive pills, in cyclic or continuous administration, and medroxyprogesterone acetate also seem to be effective (Olive et al. 2001 Stones et al. 2004). A significant benefit in terms of pelvic pain relief also is obtained with the use of nonsteroidal anti-inflammatory drugs (Olive et al. 2001 Stones et al. 2004). 

Medroxyprogesterone acetate Synthetic progestogen Treatment of menstrual disorders, endometriosis and hormone responsive cancer. Also used as long-acting contraceptive... 

Treatment with low-dose medroxyprogesterone acetate (50 and 150 mg/day) for endometriosis reduces HDL cholesterol (15) confined to the HDL2 subfraction, which was lowered by as much as 58% after 24 weeks of treatment the effect was clearly dose-related in the therapeutic dosage range. 

Endometriosis Oral contraceptive, depot injection of medroxyprogesterone acetate, GnRH agonist, danazol... 

Clinical use A major therapeutic use of the progestins is as a component of oral or implantable contraceptives. They are used in HRT to prevent estrogen-induced endometrial cancer. Large doses of medroxyprogesterone can be used to produce anovulation and amenorrhea in women with dysmenorrhea, endometriosis, or bleeding disorders. 

Medroxyprogesterone acetate (Fig. 46.13), administered by injection (Depo-Provera), orally, or delivered via lUD, effectively suppresses the HPO axis, induces anovulation, and reduces serum estrogen levels (83). This prevents menstruation and endometrial implant growth. As a result, endometriosis-related pain is minimized in approximately 90% of the patients. Drug therapy selection should reflect the fact that pharmacological therapy is likely to be required on a chronic basis. The progestins are fairly well tolerated and relatively inexpensive, but they are not without adverse effects. 

Luciano AA, Turksoy RN, Carleo J. Evaluation of oral medroxyprogesterone acetate in the treatment of endometriosis. Obstet Gynecol 1988 72 323-327. 

Cheewadhanaraks S, Choksuchat C, Dhanaworavibul K, Liabsuetrakul T. Postoperative depot medroxyprogesterone acetate versus continuous oral contraceptive piUs in the treatment of endometriosis-associated pain a randomized comparative trial. Gynecol Obstet Invest 2012 74(2) 151-6. 

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