Medroxyprogesterone acetate

Medroxyprogesterone acetate (MPA), also known as depot medroxyprogesterone acetate (DMPA) in injectable form and sold under the brand name Depo-Provera among others, is a hormonal medication of the progestin type.^[9][3] It is used as a method of birth control and as a part of menopausal hormone therapy.^[9][3] It is also used to treat endometriosis, abnormal uterine bleeding, paraphilia, and certain types of cancer.^[9] The medication is available both alone and in combination with an estrogen.^[10][11] It is taken by mouth, used under the tongue, or by injection into a muscle or fat.^[9]

Common side effects include menstrual disturbances such as absence of periods, abdominal pain, and headaches.^[9] More serious side effects include bone loss, blood clots, allergic reactions, and liver problems.^[9] Use is not recommended during pregnancy as it may harm the baby.^[9] MPA is an artificial progestogen, and as such activates the progesterone receptor, the biological target of progesterone.^[3] It also has androgenic activity and weak glucocorticoid activity. Due to its progestogenic activity, MPA decreases the body's release of gonadotropins and can suppress sex hormone levels.^[12] It works as a form of birth control by preventing ovulation.^[9]

MPA was discovered in 1956 and was introduced for medical use in the United States in 1959.^[13][14][9] It is on the World Health Organization's List of Essential Medicines.^[15] MPA is the most widely used progestin in menopausal hormone therapy and in progestogen-only birth control.^[16][17] DMPA is approved for use as a form of long-acting birth control in more than 100 countries.^[18][19] In 2022, it was the 276th most commonly prescribed medication in the United States, with more than 800,000 prescriptions.^[20][21]