PharmaceuticalInjectableProgestogenOralSynthetic progestin

Medroxyprogesterone Acetate

Also known as Depo-Provera · MPA · Provera

Written by enwyReviewed 5 Aug 20261 sources0 comments

A potent synthetic progestin used as long-acting injectable contraception (Depo-Provera), in HRT, and as an anti-androgen/testosterone suppressant in transfeminine care and hypersexuality. Strongly suppresses gonadotropins.

01 Overview

Medroxyprogesterone acetate (MPA) is a 17-hydroxyprogesterone-derived progestin. As Depo-Provera it provides three months of contraception per injection; orally it is used for endometrial protection in HRT and to treat endometriosis and abnormal bleeding. In transfeminine care it is sometimes used off-label to suppress testosterone where spironolactone or cyproterone are unsuitable.

MPA was the progestin in the estrogen-plus-progestin arm of the WHI, which found increased breast cancer and cardiovascular events versus placebo. Long-term injectable use also reduces bone mineral density, which is largely reversible after discontinuation.

02 Mechanism

Progesterone-receptor agonist with weak androgenic/glucocorticoid activity; suppresses LH/FSH, thereby lowering endogenous testosterone and inhibiting ovulation.

03 Dosing

Tier	Dose	Route	Notes
T-suppression / HRT	5–20 mg/day	Oral	Off-label 5-20 mg/day used for testosterone suppression.
Depot contraception	150 mg	IM	150 mg every 3 months (SC 104 mg alternative).

04 Effects

Effect	Magnitude	Evidence
Testosterone suppressionLowers gonadotropins and endogenous testosterone in transfeminine use.		Observational
ContraceptionHighly effective long-acting reversible contraception.		Clinical

05 Side effects

Effect	Severity	Frequency	Evidence
Reduced bone mineral densityDepot MPA lowers BMD; largely reversible after stopping.	Moderate	Common with prolonged depot use	Clinical
Weight gain and mood changesAppetite increase, weight gain and depressed mood reported.	Mild	Common	Clinical
Delayed return of fertilityFertility may take months to return after stopping depot injections.	Mild	Common after depot	Clinical

06 Legal status

United States

Prescription drug

as of Jan 2026

07 References

Risks and Benefits of Estrogen Plus Progestin (WHI, MPA arm)JAMA, 2002

08 Discussion0 comments

Create account

Discussion is moderated. No sourcing, vendor names or price talk — those comments are removed, and repeat posts are banned.

This page is reference information, not medical advice. Doses and protocols are documented as they appear in the clinical literature and in practice — describing them is not a recommendation to use them. Countermeasures listed here are not a substitute for a physician. Legal status varies by jurisdiction and changes.