Medroxyprogesterone: what it does and how to use it safely

Medroxyprogesterone (often called MPA) is a synthetic progestin used for several reasons: birth control, treating abnormal bleeding, protecting the lining of the uterus during estrogen therapy, and managing some hormone-related conditions. You’ll find it as a daily pill and as a long-acting injection (Depo‑Provera or Depo‑SubQ).

Which form you get depends on the goal. The injection gives 12 weeks of contraception from one shot; tablets are used for short-term hormone control or to trigger a period in cases like amenorrhea.

Common doses and timing

For contraception: Depo‑Provera (intramuscular) is 150 mg every 12–13 weeks. There’s also a subcutaneous version (Depo‑SubQ) at 104 mg on the same schedule. If you miss the injection by more than a few weeks, use backup contraception until your provider confirms coverage.

For short-term bleeding control or to induce a period, tablets are usually in the 2.5–10 mg range daily for several days; a common regimen for withdrawal bleeding is 5–10 mg daily for 5–10 days. For endometrial protection when using estrogen, providers often use low daily doses—your doctor will set the exact amount based on your needs.

Side effects, safety, and practical tips

Expect menstrual changes: irregular spotting at first, then possible lighter periods or no periods with the injection. Other common effects are weight change, headaches, mood shifts, and breast tenderness. Long-term use of the injection can lower bone mineral density, so if you’re on Depo‑Provera for more than two years, discuss bone health with your provider—calcium, vitamin D, and exercise help.

Don’t use medroxyprogesterone if you’re pregnant, have unexplained vaginal bleeding, active breast cancer, or severe liver disease. Tell your provider about medications like rifampin, carbamazepine, or some seizure drugs — they can lower MPA levels and make it less effective.

Thinking about fertility? After the injection, it can take several months for cycles to return; some people conceive within a few months, others wait longer. If you want to get pregnant soon, discuss choosing a different method.

Practical tips: get your injection on schedule and set reminders; if you have mood or heavy bleeding changes, call your provider; consider bone checks if you’ll use the shot long term; store tablets at room temperature and follow local rules for medicine disposal.

If you’re breastfeeding, recently had a baby, or take meds that change hormone levels, check with your clinician. Medroxyprogesterone is useful for many people but using it safely means matching the form and dose to your goals and health. Have questions about your dose or side effects? Ask your provider — they can tailor a plan that fits your life.