Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.
Blood clots: This medication has been associated with blood clots developing in the bloodstream. These blood clots may form anywhere in the body but are more noticeable when they occur in the large muscles, lung, brain (stroke), or heart (heart attack). If you experience pain in the chest or leg, unexplained shortness of breath, blurred vision or slurred speech, contact your doctor immediately.
Certain conditions such as long-term bed confinement may make blood clots more likely. Discuss with your doctor the risks and benefits of temporarily stopping this medication if you are scheduled for surgery, and let all doctors involved in your care know that you are taking this medication.
Bone loss: Medroxyprogesterone causes bone loss, and adolescent women whose bones are still forming and have not yet reached their peak bone mass should discuss any concerns with their doctor. It is not known if this will influence peak bone mass and increase the risk of osteoporosis in the future. If you are considering using this medication, discuss the risks and benefits with your doctor.
The amount of bone loss depends on how long a woman uses this medication. This bone loss may not be completely reversible. You should discuss these risks with your doctor. The risk of bone effects may be greatest in early adulthood and adolescence.
Cancer: For some women, there may be a slightly increased risk of breast cancer associated with the use of medroxyprogesterone acetate injection. Long-term studies showed no increased risk of ovarian, liver, or cervical cancer, and a reduced risk of endometrial cancer. Talk to your doctor if you have any concerns about this medication.
Cigarette smoking: There is an increased risk of negative side effects on the heart and blood vessels for women who smoke and are using medroxyprogesterone acetate. If you smoke, discuss the benefits of stopping smoking with your doctor or pharmacist. There are tools that are available to make this easier.
Depression: Hormones, such as medroxyprogesterone acetate have been known to cause mood swings and symptoms of depression. If you have depression or a history of depression, discuss with your doctor how this medication may affect your medical condition and whether any special monitoring is needed.
If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, or decreased interest in activities, or notice them in a family member who is taking this medication, contact your doctor as soon as possible.
Diabetes: Some women receiving medroxyprogesterone experience decreased blood glucose control. For this reason, women with diabetes should carefully monitor their blood glucose while receiving medroxyprogesterone acetate. Discuss with your doctor the ideal frequency with which you should check your blood glucose.
Fertility: Research indicates there is no evidence that medroxyprogesterone causes infertility. It may take some time for the injection to wear off, and most women must wait about 6 to 8 months after the last injection to start ovulating, having regular periods, and be able to become pregnant.
Fluid retention: Since progestogens may cause some degree of fluid retention, conditions such as epilepsy, migraine, asthma, or reduced heart or kidney function might be influenced by this medication. If you have any of these conditions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
High blood pressure: The fluid retention mentioned above can contribute to increased blood pressure. If you are treating high blood pressure or may be at risk of developing high blood pressure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Irregular menstrual patterns: Menstrual patterns commonly change following the use of medroxyprogesterone. This includes irregular or unpredictable bleeding or spotting or, rarely, heavy or continuous bleeding. If undiagnosed vaginal bleeding occurs, or if abnormal bleeding persists or is severe, consult your doctor.
As women continue to use medroxyprogesterone, fewer experience irregular bleeding patterns and more do not menstruate at all. By Month 12, about 55% of women no longer have periods, and by Month 24, about 68% of women using medroxyprogesterone do not have periods. Because of the prolonged effect of the medication, re-establishment of menstruation may be delayed and difficult to predict.
Liver disease: If you have liver disease or are at risk of developing liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. The doctor will probably monitor liver function with regular blood tests. If you develop signs of liver disease (such as yellowing of the skin or eyes; or swelling, pain, or tenderness in the upper abdominal area), contact your doctor as soon as possible.
Migraine and headache: Medroxyprogesterone acetate may make migraine symptoms worse. The onset or worsening of a migraine or the development of new types of recurrent, persistent, or severe headaches should be reported to your doctor. If you already experience migraine or severe headaches, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Sexually transmitted infections: This medication does not protect against sexually transmitted infections, including HIV/AIDS. For protection against these, use latex condoms.
Weight changes: Weight gain may be associated with the use of medroxyprogesterone. The majority of studies report an average weight gain of 2.5 kg at the end of one year, but only 2% of women stopped treatment due to excessive weight gain.
Pregnancy: This medication should not be used by pregnant women. To help ensure a woman is not pregnant at the time of the first injection, it is recommended that the first injection be given only within the first 5 days of the onset of a normal menstrual period, or only within the first 5 days after childbirth if the mother is not breast-feeding.
Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking medroxyprogesterone, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children. Medroxyprogesterone is not intended to be used in young women before menstruation begins (menarche).