What is Provera?
Provera is a branded prescription medicine whose active ingredient is medroxyprogesterone acetate (MPA), a progestogen, meaning it mimics the action of naturally occurring progesterone in the body. It is manufactured by Pfizer and is available in three strengths: 2.5 mg, 5 mg, and 10 mg.
Provera is licensed in the UK for several conditions, including secondary amenorrhoea (absent periods not caused by pregnancy), dysfunctional uterine bleeding (heavy or irregular periods without an underlying structural cause), and mild to moderate endometriosis. It is also used as part of hormone replacement therapy (HRT) in women who have not had a hysterectomy, to protect the lining of the uterus.
Provera should not be confused with Depo-Provera, which is an injectable contraceptive containing a higher dose of the same active ingredient. Provera is designed to help treat the conditions listed above, not for contraception.
How does Provera work?
Provera works by supplementing or mimicking the action of progesterone, one of the two key hormones that regulate the menstrual cycle.
In a normal cycle, progesterone is produced after ovulation and acts on the lining of the uterus (the endometrium), stabilising it and preparing it for a potential pregnancy. If pregnancy does not occur, progesterone levels fall, triggering the shedding of the uterine lining as a period.
When this hormonal balance is disrupted, a range of problems can occur: the lining may build up unevenly (leading to heavy or irregular bleeding), fail to develop properly (leading to absent periods), or grow outside the uterus (endometriosis).
Provera addresses these issues by providing a consistent source of progestogen activity. Depending on how it is prescribed:
- For absent or irregular periods: it triggers a withdrawal bleed when stopped, resetting the cycle
- For heavy periods: it stabilises the uterine lining, reducing excessive bleeding
- For endometriosis: taken continuously, it suppresses the growth of endometrial tissue outside the uterus
- As part of HRT: it protects the uterine lining from the stimulating effects of oestrogen
What are the benefits of using Provera?
Provera offers targeted hormonal support for a range of conditions that can significantly affect quality of life.
Regulates the menstrual cycle. For women with absent or highly irregular periods, Provera can be used to induce a withdrawal bleed and help restore a more predictable pattern.
Reduces heavy menstrual bleeding. For women with dysfunctional uterine bleeding, Provera can stabilise the uterine lining and reduce the frequency and volume of bleeding.
Manages endometriosis. Continuous use of Provera suppresses the growth and activity of endometrial tissue, helping to reduce the pain and discomfort associated with endometriosis.
Supports HRT. For women using oestrogen-based HRT who still have a uterus, Provera provides the progestogen component needed to protect the uterine lining from overstimulation.
Flexible dosing. Available in three strengths and adaptable across a range of dosing schedules, Provera can be tailored to the specific condition and individual needs of each patient.
Who can use Provera?
Provera is a prescription medicine for women. A medical consultation is required before it can be prescribed, and your prescriber will assess your suitability as part of your online consultation.
Provera may be suitable for you if you are a woman experiencing:
- Absent periods not caused by pregnancy (secondary amenorrhoea)
- Heavy or irregular periods (dysfunctional uterine bleeding)
- Mild to moderate endometriosis
- Menopausal symptoms being managed with HRT, where progestogen cover is required
Provera is not suitable if you:
- Are pregnant or suspect you may be pregnant
- Have or have had breast cancer or other progestogen-sensitive cancers
- Have unexplained vaginal bleeding that has not been investigated
- Have a history of blood clots (deep vein thrombosis, pulmonary embolism, or stroke)
- Have severe liver disease or a history of liver tumours
- Have a known allergy to medroxyprogesterone acetate or any other ingredient in the tablet
- Have porphyria (a rare inherited blood disorder)
Your prescriber will review your full medical history during your consultation to confirm whether Provera is appropriate for you.
How to take Provera
Provera is taken orally. The dose, strength, and schedule depend entirely on the condition being treated and will be specified on your prescription. Always follow your prescriber's instructions. The following are general guidance only:
Secondary amenorrhoea (absent periods): Typically 2.5 mg to 10 mg daily for 5 to 10 days, taken in the second half of the cycle. A withdrawal bleed usually occurs within 3 to 7 days of stopping.
Dysfunctional uterine bleeding: Usually 2.5 mg to 10 mg daily for 5 to 10 days, starting on the 16th to 21st day of the cycle.
Endometriosis: Treated by taking 10 mg daily for 90 consecutive days, starting on the first day of the cycle.
As part of HRT: Dosing schedules vary and will be specified by your prescriber based on your HRT regimen.
Provera tablets can be taken with or without food. If you miss a dose, take it as soon as you remember. If it is close to the time of your next dose, skip the missed one and continue as normal. Do not take a double dose to make up for a missed one.
Precautions and interactions
Unexplained bleeding. Provera should not be used to treat abnormal vaginal bleeding that has not been properly investigated. If you experience any unexpected bleeding, inform your prescriber before starting or continuing treatment.
Blood clot risk. Progestogens, including medroxyprogesterone acetate, are associated with a small increased risk of venous thromboembolism (blood clots). This risk is higher in women who smoke, are overweight, have reduced mobility, or have a personal or family history of blood clots. Inform your prescriber of any relevant risk factors.
Breast cancer. Some evidence suggests that long-term use of progestogens may be associated with a small increased risk of breast cancer, particularly when used as part of combined HRT. Discuss your personal risk with your prescriber.
Liver conditions. Provera is metabolised by the liver. It should be used with caution in women with a history of liver problems, and is contraindicated in women with severe liver disease. Inform your prescriber of any liver conditions.
Diabetes. Progestogens can affect glucose tolerance. Women with diabetes or a history of gestational diabetes should be monitored more closely during treatment.
Depression. Provera can affect mood. Women with a history of depression should be monitored during treatment and should inform their prescriber if symptoms worsen.
Drug interactions. Provera can interact with several types of medication, including:
- Enzyme-inducing medicines such as rifampicin, carbamazepine, phenytoin, and St John's Wort, which can reduce the effectiveness of Provera
- Aminoglutethimide, which can significantly reduce medroxyprogesterone acetate levels in the blood
- Ciclosporin, where Provera may increase levels, raising the risk of toxicity
Always inform your prescriber and pharmacist of all other medicines, supplements, and herbal remedies you are taking.
Pregnancy and breastfeeding. Provera must not be taken during pregnancy. It should be used with caution during breastfeeding; discuss this with your prescriber if relevant.
What are the side effects of Provera?
Like all prescription medicines, Provera can cause side effects, though not everyone experiences them. Side effects may include, but are not limited to:
Common side effects (may affect up to 1 in 10 women):
- Irregular or unpredictable vaginal bleeding or spotting, particularly in the early weeks of treatment
- Headache
- Nausea
- Breast tenderness or discomfort
- Mood changes, including low mood or depressed mood
- Changes in libido
- Fluid retention or bloating
- Weight changes
Uncommon or rare side effects:
- Skin reactions including rash, acne, or excessive hair growth (hirsutism)
- Sleep disturbances or insomnia
- Fatigue or dizziness
- Jaundice (yellowing of the skin or eyes). Stop taking Provera and seek medical advice promptly if this occurs
Serious side effects. Seek immediate medical attention if you experience:
- Sudden chest pain, shortness of breath, or coughing up blood (possible signs of a blood clot in the lung)
- Severe pain or swelling in one leg (possible sign of a blood clot in the leg)
- Sudden severe headache, vision changes, weakness, or difficulty speaking (possible signs of a stroke)
- Signs of a severe allergic reaction, including swelling of the face, lips, or throat
If any side effect concerns you, contact your prescriber or GP. You can also report suspected side effects directly to the MHRA via the Yellow Card scheme at yellowcard.mhra.gov.uk.
Note: The Patient Information Leaflet (PIL) in your medicine pack may differ from the PDF version on this website, as it may have been updated since packaging or the medicine may be from another brand.
