Provera for PCOS & the Menstrual Cycle

What to know about provera for pcos
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My doctor recommended that I take Provera to bring on my period? What is it and when should I get my period?

Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder in women of childbearing age. A hallmark feature of PCOS is irregular or absent periods and is due to an imbalance of sex hormones. Typically women with PCOS will have high levels of androgens (like testosterone) and luteinizing hormone (LH), whereas they may have low levels of progesterone.

Women who don't have regular menstrual cycles for prolonged periods of time are at an increased risk for endometrial hyperplasia, This condition occurs when the uterine lining fails to shed, resulting in a thick uterine lining, increasing the risk for uterine cancer.  

If you have PCOS haven't been getting your period or have abnormal bleeding, chances are your doctor has discussed using Provera. 

Provera (medroxyprogesterone) is a synthetic form of progesterone, which is a hormone naturally produced after ovulation. When the levels of progesterone begin to decline, it triggers the start of the next menstrual period. Women with PCOS tend to ovulate infrequently, so they don’t produce progesterone as readily. Taking Provera simulates the latter phase of their cycle and fools the body into thinking that ovulation has occurred.

Most women who take Provera get their periods within a few days of stopping the pill (it’s taken every day for five to 10 days, depending on your doctor’s preferences).

It’s not unusual, though, to begin bleeding before you finish the course of pills or not until two weeks after you finished the pills. If it’s been longer than two weeks since you finish taking the prescribed number of pills and you still haven’t gotten a period, you should notify your doctor.

What to Expect From Taking Provera

Ideally, you should get a period after taking Provera as prescribed, however, not all women with PCOS do.

Since Provera is a hormone, it may cause side effects, with the most common ones being headaches, breast tenderness, and mood changes. These side effects should subside a few days after taking Provera. Other side effects include:  

Side Effects:

  • Change in menstrual bleeding or flow
  • Acne
  • Migraines
  • Fatigue

If you note any of the following side effects, please contact your physician immediately:

  • Visual or speech change
  • Severe migraine
  • Sudden difficulty breathing or shortness of breath
  • Sudden and severe mood changes
  • Severe abdominal, chest or leg pain
  • pain, swelling, warmth, redness, or tenderness in one leg only
  • faintness
  • weakness or numbness of an arm or leg

Provera Dosage

Provera is available in 2.5, 5.0 and 10-milligram tablets. Many practitioners will prescribe 5 mg or 10 mg each day to induce a withdrawal bleed. Typical dosage is 1 tablet once a day for 5, 7 or 10 days as determined by your doctor.

Other Things To Know About Taking Provera

Provera can interact with certain anti-seizure medications, St. John’s Wort, and Rifampin. Make sure to tell your doctor about any medications or dietary supplements you are taking.

Provera is contraindicated in pregnancy. Make sure to tell your physician if you think you may be pregnant.

Sometimes your physician will require that you take either a blood or urine pregnancy test before taking this medication.

Provera is also contraindicated if there is a prior history of breast, ovarian, or uterine cancer; blood clots, stroke, and seizures.

Source: Provera product information website 

Updated by Angela Grassi, MS, RDN, LDN

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