Progestogens medroxyprogesterone

High-dose progestogen (medroxyprogesterone) - useful to treat vasomotor symptoms with no increased risk of cardiovascular conditions. 

The most commonly used oral progestogens are medroxyprogesterone acetate, micronized progesterone, and norethisterone acetate. 

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

Estrogen/progestogen combinations, oral conjugated estrogens/ medroxyprogesterone ethinyl estradiol/norethindrone acetate mestranol/norethindrone... 

It has long been considered that the risk of endometrial carcinoma may be somewhat reduced by HRT, but that the risk is affected by the dose of progestogen used, if any. In a recent population-based case-control study covering 647 cases and 1209 controls, users of estrogen + medroxyprogesterone acetate (MPA) given for 10-24 days monthly in a dose of 100 mg/month or more showed the same risk of endometrial cancer as women not using HRT... 

Saure A, Planellas J, Poulsen HK, Jaszczak P. A doubleblind, randomized, comparative study evaluating clinical effects of two sequential estradiol-progestogen combinations containing either desogestrel or medroxyprogesterone acetate in climacteric women. Maturitas 2000 34(2) 133 12. 

Other information on medroxyprogesterone will be found in other monographs that deal with progestogens ... 

Medroxyprogesterone acetate is given in a relatively high dose for hormonal contraception and acts primarily by inhibiting ovulation. However, as with the other progestogen-only contraceptives, other mechanisms probably play a very significant role. It is extremely effective, with less than one pregnancy per 100 woman-years. 

There is a disputed effect on carbohydrate metabolism, but it is at most mild and there is certainly no precipitation of diabetes in healthy women. Carbohydrate metabolism was unaffected by medroxyprogesterone in one study in which there was modest impairment of glucose tolerance among users of levonorgestrel-containing, low-dose combined oral contraceptives and progestogen-only tablets (18). 

Kamau RK, Maina FW, Kigondu C, Mati JK. The effect of low-oestrogen combined pill, progestogen-only pill and medroxyprogesterone acetate on oral glucose tolerance test. East Afr Med J 1990 67(8) 550-5. 

Progestogens with a degree of mineralocorticoid activity will tend to cause water and salt retention and to increase blood pressure in susceptible subjects. However, effects on blood pressure can be variable for example, medroxyprogesterone has been variously reported to cause a fall in blood pressure in some initially hypertensive patients while rapidly increasing diastolic pressure in some other women, or to have no effect on blood pressure at all. 

For those who do not respond to tamoxifen, second-line therapy includes progestogens, e.g. megestrol or medroxyprogesterone. Should fluid reten-... 

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