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PubMedDate not supplied

Comparison of physical and emotional side effects of progesterone or medroxyprogesterone in early postmenopausal women.

OBJECTIVE: To compare the mood and somatic effects during the initial 2 months of medroxyprogesterone acetate (MPA) or progesterone combined with conjugated equine estrogen (CEE) in early postmenopausal women. DESIGN: Twenty-three nondepressed, early postmenopausal women (average age, 52.5 years) completed a 91-day, single-blind pilot study with the following sequence of treatments: 1 week of no substance; 2 weeks of placebo; 2 weeks of progestogen only; 1 week of placebo; and 2 months of "standard hormone replacement therapy cycles," which consisted of (in order) 2 weeks of 0.625 mg CEE, 2 weeks of CEE plus progestogen, 2 weeks of CEE, and 2 weeks of CEE plus progestogen. Ten women who completed the study received MPA (5 mg/day) as their progestogen, and 13 who completed the study received micronized, oil-suspended progesterone (200 mg/day) as their progestogen. All participants made daily assessments of mood using the Profile of Mood States and daily recordings of somatic symptoms. All subjects had plasma follicle-stimulating hormone of greater than 35 IU/L and had not had spontaneous vaginal bleeding for more than 1 year. RESULTS: None of the hormone treatments had a detectable effect on mood. MPA users reported more vaginal bleeding and breast tenderness than progesterone users. CONCLUSIONS: In contrast with the widely held belief among psychiatrists that progesterone depresses mood, neither of the progestogens we used in normal, nondepressed and nonanxious women showed this effect. Absence of an effect on mood was also found when the results of the two progestogens were combined. The lesser side effects of the micronized progesterone-containing regimen suggest that some women may prefer it to an MPA-containing regimen.

Breast↗
PubMedDate not supplied

Medroxyprogesterone acetate versus norethisterone: effect on estradiol-induced changes of markers for endothelial function and atherosclerotic plaque characteristics in human female coronary endothelial cell cultures.

OBJECTIVE: Progestin addition to estradiol (E(2)) replacement therapy may lead to a deterioration of beneficial effects on the vasculature. The effect of the two clinically most common progestins, medroxyprogesterone acetate (MPA) and norethisterone (NET), during continuous combination with E(2) on the synthesis of markers for coronary endothelial function, atherosclerotic plaque initiation, and plaque formation was investigated in human female vascular cell cultures and compared with that of E(2) alone. DESIGN: Endothelial cell cultures from human female coronary arteries were used to evaluate the effect of progestin addition to E(2) on the production of the following endothelial markers: prostacyclin, endothelin, plasminogen activator inhibitor-1, E-selectin, intercellular adhesion molecule-1, monocyte chemoattractant protein-1 (MCP-1), and the precursor of matrix metalloproteinase-1 (pro-MMP-1). E(2) was tested at 0.1 microM, 1 microM, and 10 microM alone and in equimolar combinations with MPA or NET. The markers were determined by enzyme immunoassays in the cell supernatant. RESULTS: E(2) induced a significant increase of endothelial prostacyclin production and was able to significantly decrease the synthesis of endothelin, plasminogen activator inhibitor-1, E-selectin, and intercellular adhesion molecule-1. Neither MPA nor NET addition negatively interfered with these E(2)-induced benefits. However, MPA antagonized the E(2)-induced significant reduction of MCP-1 synthesis, with the difference between both progestins being significant (p < 0.01). Interestingly, an enhancement of the positive E(2)-effect on pro-MMP-1 production was observed by the addition of both MPA and NET (p < 0.01). CONCLUSION: E(2) can positively influence various markers of endothelial function. Addition of MPA or NET can elicit different effects, which has been demonstrated for the first time in human coronary cell cultures. No impact was found on markers representing primarily vasotonus and thrombogenicity. In terms of MMP-1, which is crucial for atherosclerotic plaque stability, an enhancement of the beneficial E(2) effect was observed. However, regarding MCP-1, contrary effects of progestins cannot be excluded. This indicates that progestins may differ in their effects, particularly in the early stages of atherosclerosis, which has also been supported by other studies.

Biomarkers↗
PubMedDate not supplied

Medroxyprogesterone-induced endocrine alterations after menopause.

OBJECTIVE: To evaluate endocrine responses to short-term medroxyprogesterone acetate (MPA) administered as a respiratory stimulant in postmenopausal women with mild nocturnal hypoxemia. DESIGN: Open-label trial with 14-day MPA (60 mg daily) and 3-week follow-up posttreatment. Serum concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, and insulin-like growth factor-I (IGF-I) were assessed at baseline, while on MPA and at the 3-week washout in eight subjects. RESULTS: With MPA, FSH decreased by 47.5% (p < 0.01) and LH by 64.9% (p < 0.001), whereas IGF-I increased by 39.6% (p < 0.01). FSH and LH remained suppressed at the 3-week washout (-23.8%, p < 0.05 and -44.3%, p < 0.01, respectively). IGF-I returned to pretreatment level at the 3-week washout. Neither serum estradiol nor progesterone concentrations changed during or after progestogen therapy. CONCLUSIONS: Daily administration of MPA (60 mg) for 2 weeks has both immediate (FSH, LH and IGF-I) and sustained (FSH, LH) effects up to 3 weeks after treatment. Therefore, prolonged MPA-induced effects should be taken into account when interpreting hormone assessments after progestogen therapy.

Aged↗
PubMedDate not supplied

Combination therapy of low-dose medroxyprogesterone acetate and oral estrogen does not affect endothelial function in the forearms of postmenopausal women.

OBJECTIVE: We investigated whether low-dose medroxyprogesterone acetate (MPA) combined with oral estrogen had adverse effects on endothelial function compared with oral estrogen alone in postmenopausal women with mild hypercholesterolemia. DESIGN: Subjects were divided into two groups. One group received conjugated equine estrogen (CEE, 0.625 mg daily) orally for the first 3 months, followed by estrogen combined with MPA (2.5 mg daily) orally for an additional 3 months ( = 26). The other group received no treatment (control group, = 12). Forearm blood flow (FBF) during reactive hyperemia and after sublingual nitroglycerin administration was measured by strain-gauge plethysmography. Nitrite/nitrate, angiotensin-converting enzyme, and lipid concentrations were measured in the serum. RESULTS: Both CEE and CEE combined with MPA significantly increased the FBF during reactive hyperemia. This increase was similar in both active treatment phases. No changes were seen in controls. FBF after sublingual nitroglycerin did not change over 6 months in either group. Significant and similar increases in serum concentration of nitrite/nitrate and plasma renin activity as well as decreases in angiotensin-converting enzyme activity were found in both treatment phases. No such changes occurred in the control group. There was no significant increase in high-density lipoprotein cholesterol or decrease in low-density lipoprotein cholesterol between the treatment phases. Likewise, no such changes were observed in the control group. CONCLUSIONS: Our 6-month study suggests that the addition of low-dose MPA with CEE had no adverse effects on forearm resistance artery endothelial function compared with CEE alone.

Blood Flow Velocity↗
PubMedDate not supplied

Body mass index does not influence response to treatment, nor does body weight change with lower doses of conjugated estrogens and medroxyprogesterone acetate in early postmenopausal women.

OBJECTIVE: To determine the effects of lower doses of conjugated estrogens (CE) alone or in combination with medroxyprogesterone acetate (MPA) on body weight and to evaluate the influence of body mass index (BMI) on the effect of lower-dose CE or CE/MPA on vasomotor symptoms, vaginal atrophy, bone mineral density (BMD), endometrial safety, and side effects such as endometrial bleeding and breast pain. DESIGN: In this large clinical trial [the Women's Health, Osteoporosis, Progestin, Estrogen (Women's HOPE) study], 2,673 healthy, postmenopausal women with intact uteri were randomized for 1 year of CE 0.625, CE 0.625/MPA 2.5, CE 0.45, CE 0.45/MPA 2.5, CE 0.45/MPA 1.5, CE 0.3, CE 0.3/MPA 1.5 (all doses mg/d), or placebo. Weight, BMI, number and severity of hot flushes, vaginal atrophy (as determined by the vaginal maturation index), bleeding profiles, breast pain, and endometrial biopsies were evaluated. A subset of 822 women was randomized into a 2-year substudy to evaluate changes in BMD with lower-dose CE or CE/MPA regimens. RESULTS: After 1 year of treatment, a small but significant (P < 0.05) gain in body weight from baseline was observed in all arms of the study, the largest increase in body weight occurring in the placebo group [1.15 +/- 0.21 (SE) kg]. Body mass index had no significant effect on changes from baseline for vasomotor symptoms, bleeding patterns, vaginal atrophy, BMD, endometrial safety, or breast pain when analyzed both by analysis of covariance with baseline BMI as covariate or when participants were grouped into BMI less than 25 kg/m and BMI of 25 kg/m or greater. In placebo-treated women, vaginal atrophy was significantly greater (P < 0.05) in women with a BMI less than 25 kg/m compared with a BMI of 25 kg/m or greater. CONCLUSIONS: Lower- and standard-dose regimens of CE or CE/MPA are not associated with greater weight gain than placebo. In addition, BMI does not seem to influence effects of these regimens on vasomotor symptoms, vaginal atrophy, bleeding profiles, BMD, endometrial safety, or breast pain.

Body Mass Index↗
PubMed2005

The effects of progesterone, medroxyprogesterone acetate, and norethisterone on growth factor- and estradiol-treated human cancerous and noncancerous breast cells.

OBJECTIVE: Mitogenic growth factors from stromal breast tissue and estrogens are important in growth regulation of breast cells and may modify different responses dependent on the choice of progestogens. The effects of the acknowledged pharmacologically significantly different progestogens, progesterone, medroxyprogesterone acetate (MPA), and norethisterone, were investigated in breast cells treated with growth factor and/or estradiol, comparing normal and primary cancer cells for the first time. DESIGN: MCF10A (human epithelial, estrogen-receptor-negative and progesterone-receptor-negative normal breast cells) were incubated with progestogens at 1 microM and 100 nM for 7 days and epidermal growth factor, fibroblast growth factor, and insulin-like growth factor at 1 pM. HCC1500 (human estrogen-receptor-positive and progesterone-receptor-positive primary breast cancer cells) were incubated in the same way with growth factors and/or estradiol at 100 pM. Cell proliferation rate was measured by the ATP assay, whereas cell death was measured by photometric enzyme immunoassay. Ratios of cell death to proliferation were calculated from these results. RESULTS: In combination with growth factors, MPA reduced the ratio in favor of a proliferative effect in MCF10A cells, followed by norethisterone. Progesterone had no significant effect on the growth factor response. In HCC1500 cells, MPA with growth factors increased the ratio favoring inhibition, norethisterone had a proliferative effect, and progesterone had no significant effect. In combination with estradiol, MPA increased the ratio to inhibition to the greatest extent, followed by norethisterone and progesterone at 1 muM. In combination with growth factors and estradiol, MPA and norethisterone both showed an inhibitory effect, whereas progesterone had no significant effect. CONCLUSION: Certain progestogens are able to induce the proliferation of benign or malignant human breast cells independently of the effects of growth factors and estradiol. Therefore, the choice of progestogen may be important in terms of influencing a possible breast cancer risk.

Apoptosis↗
PubMedDate not supplied

Medroxyprogesterone acetate inhibits the cardioprotective effect of estrogen in experimental ischemia-reperfusion injury.

OBJECTIVE: Results from recent clinical trials of estrogen and progestogen therapy (EPT) suggest that some progestogens may interfere with the cardiovascular benefits of estrogen (E). The aim of this study was to investigate whether medroxyprogesterone acetate (MPA) modifies the protective effect of E in experimental ischemia-reperfusion (IR) injury in vivo and in vitro in the rat. DESIGN: Ovariectomized female Wistar rats (250-280 g, n = 61) received E, MPA, E and MPA, or placebo subcutaneously. Fourteen days later, hearts were isolated and perfused with Krebs Henseleit for in vitro experiments or left in situ for in vivo experiments. In both cases, the left coronary artery was occluded for 45 minutes, followed by 2 hours of reperfusion. RESULTS: In vivo E significantly reduced the necrotic zone of reperfused hearts (21.8% +/- 1.7% of area at risk) compared with placebo (42.8% +/- 4.8% area at risk; P < 0.05). This protection was reversed by co-administration of MPA with E (necrotic zone 38.2% +/- 6.1% area at risk). The influence of E on neutrophil infiltration was demonstrated by its ability to reduce myocardial myeloperoxidase activity (0.2 +/- 0.1 U/g tissue) relative to placebo (1.3 +/- 0.5 U/g tissue; P < 0.05). Myocardial myeloperoxidase activity was significantly increased to 1.1 +/- 0.3 U/g tissue in rats receiving E and MPA. However, MPA also reversed the protective effect of E in neutrophil-free buffer-perfused hearts, suggesting that additional mechanisms are involved. CONCLUSION: In this study, we showed that the administration of MPA can inhibit the effects of E that lead to protection of the myocardium from reperfusion injury and that this involves both neutrophil-dependent and neutrophil-independent mechanisms.

Animals↗
PubMed2005

Parenteral medroxyprogesterone for the management of luteinizing hormone releasing hormone induced hot flashes in men with advanced prostate cancer.

PURPOSE: Luteinizing hormone releasing hormone (LHRH) agonist therapy for advanced prostate cancer can manifest significant side effects affecting quality of life, most notably hot flashes. This study evaluated the effectiveness of parenteral medroxyprogesterone acetate (MPA) in reducing the frequency and severity of these hot flashes. MATERIALS AND METHODS: A multi-institutional retrospective review of hot flashes from LHRH therapy for prostate cancer was conducted. The hot flashes were quantified and the severity was graded (3-point analogue scale) before and after treatment with MPA. Two doses of MPA (400 or 150 mg intramuscularly) were administered. Statistical analysis (Student's t test) evaluated the quantity of hot flashes, the quality of hot flashes, and dose effectiveness. RESULTS: A total of 48 men (40 at 400 mg, 8 at 150 mg) with a mean age of 71.4 years (range 54 to 87) from 3 institutions were evaluated. There were 91% with symptomatic improvement with MPA, and half (46%) had a complete response defined as total elimination of hot flashes. The median number of the hot flashes per day decreased from 4 to 1 and the median severity score decreased from 2 to 1 (p <0.05). Significance was not achieved comparing the 2 doses. Complete responders were not noted with the 150 mg dose. Anticipated response to MPA did not correlate with the number or severity of the hot flashes. CONCLUSIONS: This study is the first multi-institutional evaluation of hot flashes demonstrating significant reduction in quantity and severity with MPA. Based on these data we now manage hot flashes associated with LHRH analogues with 400 mg of MPA.

Androgen Antagonists↗
PubMed2006

Incidence of galactorrhea in young women using Depot-Medroxyprogesterone Acetate.

Galactorrhea is rarely mentioned as a possible side effect of the use of Depot-Medroxyprogesterone Acetate (DMPA). Over the last few years, we have noticed an increased number of patients complaining of galactorrhea. A review of clinical data showed that between 1999 and 2005, 360 adolescents in our clinic used DMPA for at least 6 months. After medical follow-up, 13 (3.6%) of these patients were found to have developed galactorrhea. The mean age of the patients was 19.4 years with a range from 13-24. Prolactin levels in these patients were normal, and in all subjects, the galactorrhea resolved spontaneously within the next year in both patients who continued use and those who discontinued use of DMPA. It appears that galactorrhea is a benign side effect and as previous reports have suggested, it did not seem to be related to changes in Prolactin levels in our patients. It is thought that this is a progesterone-mediated effect. We believe that reassurance and education of patients is sufficient and there is no evidence of need for further intervention. Since the sample size is small in this study, additional research is recommended as to validate the presence of progesterone-mediated effects secondary to the use of DMPA.

Adolescent↗
PubMed2006

Successful treatment of depot medroxyprogesterone acetate-related vaginal bleeding improves continuation rates in adolescents.

High discontinuation rates for depot medroxyprogesterone acetate (DMPA) in adolescents may contribute to the number of unintended pregnancies. Many cite vaginal bleeding as a reason for discontinuing DMPA use. In this study, we attempted to determine if treating DMPA-associated vaginal bleeding with monophasic oral contraceptive pills (OCP) raised continuation rates. A total of 131 patients who reported vaginal bleeding while on DMPA were included in this study and 83 were treated with monophasic OCP. Of those who received OCP, 38.7% reported that vaginal bleeding stopped completely, 51.8% reported that vaginal bleeding stopped temporarily, and 6.0% reported no change. Overall, 94% of enrolled patients who received OCP as a treatment for DMPA-associated vaginal bleeding continued DMPA use. Our findings indicate that vaginal bleeding due to DMPA can be successfully treated, leading to improvement in continuation rates.

Adolescent↗
PubMed1994

Modulation of adriamycin resistance in human breast carcinoma MCF-7 cells in vitro and in vivo by medroxyprogesterone acetate.

The combination effect of adriamycin (ADM) and medroxyprogesterone acetate (MPA) was examined in vitro against human breast carcinoma MCF-7 and its ADM-resistant line (MCF-7/ADM). MCF-7 cells, which are positive for estrogen receptors, progesterone receptors and high-affinity MPA-binding activity, were more susceptible to the growth-inhibitory activity of ADM or MPA than MCF-7/ADM cells. A combination effect of ADM and MPA was observed against MCF-7/ADM cells, which are negative for steroid receptors, and furthermore against human nasopharynx carcinoma KB and its ADM-resistant line KB-A1. This combination effect of ADM and MPA against MCF-7/ADM cells was demonstrated to be synergistic by using the median effect plot method. The activity of MPA was almost equivalent to that of chlormadinone acetate or tamoxifen, greater than that of progesterone, and less than that of verapamil. The accumulation of ADM in MCF-7/ADM cells was enhanced by treatment with 10 microM MPA as well as 10 microM verapamil. The efflux of accumulated ADM from MCF-7/ADM cells was also partially inhibited by treatment with MPA or verapamil. MPA augmented the growth-inhibitory activity of ADM against MCF-7/ADM tumors inoculated into nude mice, although statistical significance was not observed. It is suggested that the clinical advantage of the combination of MPA with ADM against advanced breast cancers may be partly explained by the modulation of ADM resistance by MPA.

Animals↗
PubMed1995

Inhibitory effects of medroxyprogesterone acetate on mouse endometrial carcinogenesis.

The present study was undertaken to examine the effects of cyclic administration of low-dose progestogen on endometrial carcinogenesis in mice. A total of 115 female ICR mice, 10 weeks of age, were divided into four experimental and control groups. Mice in groups 1-3 received laparotomy and were injected with N-methyl-N-nitrosourea (MNU) solution at a dose of 1 mg/100 g body weight to the left uterine tube and with normal saline to the right uterine tube. From one week after the MNU exposure, groups 1 and 2 were given 5 ppm 17 beta-estradiol (E2)-containing diet throughout the experiment. Mice in group 1 received 5 s.c. injections of medroxyprogesterone acetate (MPA) (2 mg/mouse) at intervals of 4 weeks from week 7. Group 3 was treated with MNU/normal saline alone. Group 4 consisted of mice treated with MPA alone. At the termination of the experiment (week 30), all animals were killed and autopsied for pathological examinations. It was found that adenocarcinomas and preneoplastic lesions developed in the bilateral uterine corpora in mice of groups 1-3. MPA treatment significantly decreased the weight of the uterine corpus (P < 0.05) and the incidences of endometrial adenocarcinoma and atypical or adenomatous (P < 0.001) but not cystic glandular hyperplasias in the MNU/E2-treated groups. Additionally, MPA treatment tended to decrease the proliferating cell nuclear antigen-labeling index in endometrial glandular cells. These data indicate that MPA, even at low dose, has an inhibitory effect on mouse endometrial carcinogenesis induced by MNU and E2.

Animals↗
PubMed1990

Health, growth and sexual development of teenagers exposed in utero to medroxyprogesterone acetate.

General health, growth and sexual development were evaluated in 74 teenage boys and 98 girls who had been exposed to medroxyprogesterone acetate (MPA) in utero, and 385 boys and 448 girls not exposed. In this 17-year prospective study, the ascertainment of the end points was 'double blind' in that neither the interviewer nor the subject was aware of our interest in MPA. On average, girls exposed to MPA reported reaching the menarche 4 months earlier than the comparison group. This difference disappeared, however, in a multiple regression analysis taking into account social class, the mother's age at menarche and height of the girl's mother and father. Boys exposed to MPA reported their growth spurt to have occurred an average of 6 months earlier and voices to have broken 5 months earlier than unexposed boys. Again, the differences between them and the comparison group disappeared after controlling for confounding variables. There were no significant differences between the MPA-exposed and comparison groups in a wide variety of indices of health reported by the teenagers' mothers. These findings are consistent with the hypothesis that intrauterine exposure to MPA, in the doses used for pregnancy maintenance or for contraception, poses no threat to the long-term health and development of the progeny.

Adolescent↗
PubMed2000

Contraception in diabetic women: comparative metabolic study of Norplant, depot medroxyprogesterone acetate, low dose oral contraceptive pill and CuT380A.

OBJECTIVE: To evaluate the long-term intake of Norplant, depot medroxyprogesterone acetate (DMPA) and low dose oral contraceptive pill (OCs) on glycemic control, lipoprotein metabolism and coagulation profile in diabetic women. METHODS: Prospective comparative study including 80 uncomplicated controlled diabetic women. Twenty women allocated to each group. Clinical, metabolic and coagulation status were followed up at 3, 6 and 9 months' visits. RESULTS: Fasting blood sugar increased in OCs and DMPA users. Total cholesterol (TC) and LDL-cholesterol (LDL-C) decreased in all groups except DMPA where it increased. Triglyceride (TG) only increased in OCs group. HDL-cholesterol (HDL-C) increased with OCs and decreased with Norplant and DMPA. Compared to IUD users, significantly higher percentage TG and HDL-C and lower LDL-C were observed in OCs users, while DMPA users had significantly higher TC and LDL-C and lower HDL-C. Partial thromboplastin time was prolonged in Norplant users. CONCLUSION: In diabetics, Norplant results in minimal metabolic alterations followed by OCs while DMPA has unfavorable outcome.

Adult↗
PubMed1993

Transdermally administered oestradiol combined with oral medroxyprogesterone acetate: the effects on lipoprotein metabolism in postmenopausal women.

OBJECTIVE: To investigate the effects of two doses of transdermally applied oestradiol on lipid and lipoprotein metabolism in climacteric women. DESIGN: A randomised double blind cross-over comparison. SETTING: Departments of Obstetrics and Gynaecology, Ostra and Sahlgren's Hospital, Göteborg and Karolinska Hospital, Stockholm, Sweden. SUBJECTS: Fifty-two women with climacteric symptoms were treated with oestradiol transdermally applied (50 micrograms and 100 micrograms/24 h). A daily dose of 5 mg oral medroxyprogesterone acetate was added 14 days each treatment cycle of four weeks. INTERVENTIONS: Blood samples were drawn after an overnight fast before and after four and eight months of treatment. MAIN OUTCOME MEASURES: Assays for serum triglycerides and cholesterol as well as low density lipoprotein (LDL) and high density lipoprotein (HDL) cholesterol including the subfractions HDL2 and HDL3 were performed. RESULTS: Significant decrements were found in triglycerides and serum and LDL cholesterol during treatment with both doses. A modest rise in HDL2 cholesterol was observed after treatment with the 100 micrograms/24 h dose. CONCLUSIONS: The serum lipid and lipoprotein profile encountered in these women was similar to that reported with oral formulations except for a decrease in triglycerides. The metabolic differences between the two doses of transdermal oestradiol is probably of minor clinical significance in normal postmenopausal women.

Administration, Cutaneous↗
PubMed1996

Protective effect of depot-medroxyprogesterone acetate on surgically treated uterine leiomyomas: a multicentre case--control study.

OBJECTIVE: To assess the protective effect of depot-medroxyprogesterone acetate (DMPA) on uterine leiomyomas. DMPA has been widely used in Thailand for many years; uterine leiomyomas is the most common female tumour. DESIGN: A multicentre hospital-based case--control study. SETTING: University and regional hospitals. PATIENTS: Cases were all newly diagnosed patients with pathologically proven diagnosis of uterine leiomyomas, who were admitted to eight hospitals in three regions of Thailand from January 1991 to June 1993. Three controls matched with cases by sex, age within five years and date of admission within three months were recruited. MAIN OUTCOME MEASURES: Information on socio-demographic factors, personal and family history, current disease, reproductive and contraceptive history was collected from cases and controls by interview. RESULTS: There were 910 cases and 2709 controls. After univariate and unconditional multiple logistic regression analysis, risk factors associated positively with uterine leiomyomas are tubal ligation, family history of uterine leiomyomas, higher education, obesity and abortion. In contrast, DMPA, use of oral contraceptives, higher parity and smoking are associated with a lower relative risk suggesting that they have a protective effect against uterine leiomyomas. This causative relation is further strengthened by the strong duration-response relation between DMPA and uterine leiomyomas. This protection may persist for more than 10 years after the last dose. CONCLUSION: We have demonstrated a strong, duration dependent protective effect of DMPA against uterine leiomyomas.

Adult↗
PubMed2000

A prospective study on the effects of depot medroxyprogesterone acetate on trabecular and cortical bone after attainment of peak bone mass.

OBJECTIVE: To study the annual change of bone mass in women aged 30-45 years being treated with depot medroxyprogesterone acetate (DMPA) in order to evaluate whether the bone mass depends on the duration of DMPA use or the oestradiol level. DESIGN: Prospective longitudinal study over an interval of 12 months. SETTING: A family planning centre of a university hospital. PATIENTS: Thirty-six current users of DMPA. INTERVENTIONS: Injection of 150 mg DMPA every 12 weeks. MEASUREMENTS: Bone mass was measured at the distal radius by peripheral quantitative computed tomography (reproducibility 0.3%). RESULTS: Mean annual changes (SD) in trabecular and cortical bone mass were 0.06 (1.6%) [P = 0.8] and -0.26% (0.6) [P < 0.04]. The decrease in cortical bone mass was not significant because the changes were within the precision error of the method used for the measurements. Duration of DMPA use and oestradiol levels were not associated to the bone parameters. CONCLUSION: We did not find a negative impact of DMPA on the bone mass of premenopausal women aged 30-45 years.

Adult↗
PubMed1982

Augmentation of exercise ventilation by medroxyprogesterone acetate.

The influence of medroxyprogesterone acetate (MPA) on exercise performance was studied in a double-blind cross-over trial using six normal males to compare the exercise performance changes to those observed in a previous study of exercise responses of female subjects during the follicular and luteal phase of the menstrual cycle. A maximal progressive work exercise test on a cycle ergometer was performed after 2 weeks of placebo or MPA administration. Although five of six subjects spontaneously complained of increased exertional dyspnoea on MPA, no significant decreases were documented in maximal exercise time or in maximal oxygen consumption. A mean increase in exercise ventilation of 19% at low levels of exertion and 26% at high levels of exertion was documented, but no subject demonstrated evidence of ventilatory limitation. The increases in exercise ventilation observed in these male subjects after MPA administration were larger than those observed in the previous study comparing exercise ventilatory responses during follicular and luteal phases of the menstrual cycle. It seems possible that some other exercise-related modulator of the ventilatory response to exercise under the influence of progesterone is present in either male subjects receiving MPA or women with normal hormonal cycles.

Adult↗