Provera contains medroxyprogesterone, a synthetic progestogen. It is prescribed for irregular, absent or heavy periods, endometriosis, and as part of hormone replacement therapy. Depo-Provera is a different product — a long-acting contraceptive injection. Provera tablets are not a contraceptive.
What is Provera?
Provera is Schedule 4 in South Africa — prescription-only:
| Product | Contains |
|---|---|
| Provera | Medroxyprogesterone 5 mg tablet |
| Provera | Medroxyprogesterone 10 mg tablet |
| Provera | Medroxyprogesterone 100 mg tablet |
| Provera | Medroxyprogesterone 500 mg tablet |
| Depo-Provera | Medroxyprogesterone 150 mg/ml injection |
The 5 mg and 10 mg tablets are the common gynaecological strengths. The 100 mg and 500 mg tablets are used at much higher doses in specialist settings, including some cancers — a completely different context.
Provera tablets and Depo-Provera are not the same thing, and confusing them matters. Depo-Provera is the three-monthly contraceptive injection, widely used in South Africa. Provera tablets are not a contraceptive and do not prevent pregnancy. If you need contraception, this is not it.
Medroxyprogesterone is a progestogen — a synthetic version of progesterone, the hormone that dominates the second half of the menstrual cycle.
Understanding progesterone’s natural role explains most of what Provera does. After ovulation, progesterone stabilises the endometrium (the womb lining), holding it in a settled, secretory state. When progesterone falls at the end of a cycle, the lining sheds — that is a period.
Provera reproduces that:
- Taken for a set number of days then stopped, the withdrawal triggers a period. This is how it is used to bring on a period, or to regulate an erratic cycle.
- Taken continuously, it keeps the lining stable and thin, reducing heavy or irregular bleeding.
- Added to oestrogen in HRT, it protects the womb lining. This is not optional — oestrogen alone thickens the endometrium and raises the risk of endometrial cancer, and a progestogen prevents that. Women who have had a hysterectomy generally do not need it.
What is Provera commonly used for?
- Irregular or absent periods (amenorrhoea), to induce a withdrawal bleed or regulate the cycle.
- Heavy or prolonged menstrual bleeding.
- Abnormal uterine bleeding, once serious causes have been excluded.
- Endometriosis, to suppress the tissue causing pain.
- Endometrial hyperplasia, thickening of the womb lining.
- As the progestogen part of HRT, alongside oestrogen.
- Delaying a period, occasionally, for an event or travel.
- Some cancers, at the much higher strengths, in specialist care.
It treats the symptom or the hormonal pattern, not always the cause. Irregular bleeding has many possible causes — polycystic ovary syndrome, thyroid disease, fibroids, polyps, pregnancy, and, importantly, endometrial cancer. Persistent abnormal bleeding, especially after menopause, needs investigation before it is simply treated.
How Provera fits into this medicine category
| Group | Examples | Role |
|---|---|---|
| Progestogens | Medroxyprogesterone (Provera), norethisterone | Cycle control, heavy bleeding, HRT |
| Injectable progestogen | Depo-Provera | Long-acting contraception |
| Combined hormonal contraceptives | Oestrogen + progestogen pills | Contraception, cycle control |
| HRT | Oestrogen with a progestogen | Menopausal symptoms |
| Hormonal IUD | Levonorgestrel IUS | Heavy bleeding and contraception together |
| NSAIDs | Naproxen, mefenamic acid | Period pain and heavy bleeding, non-hormonally |
| Erectile dysfunction treatments | Sildenafil-type medicines | Unrelated; different part of this category |
For heavy periods where contraception is also wanted, a hormonal IUD is often more effective than tablets and worth asking about. See the sexual health and urology medicines hub.
What to check before using Provera
Take it exactly as prescribed, for the specific days you were told. With cyclical use, the timing is what produces the intended effect — taking it irregularly generally produces irregular bleeding.
Do not rely on it for contraception. Use another method if you need one.
Tell your doctor or pharmacist if you:
- Are or might be pregnant. Provera is not used in pregnancy, and pregnancy should be excluded before starting.
- Are breastfeeding.
- Have had a blood clot — deep vein thrombosis or pulmonary embolism — or have a clotting disorder or a family history of clots.
- Have had a stroke, heart attack or angina.
- Have breast cancer, or another hormone-sensitive cancer, or a history of one.
- Have liver disease, or have had jaundice in pregnancy.
- Have undiagnosed vaginal bleeding. This needs investigating first — treating the bleeding without knowing its cause can delay a diagnosis.
- Have migraine, particularly with aura.
- Have diabetes, high blood pressure, epilepsy, asthma or depression.
- Smoke, especially over 35.
- Are immobile, or due for surgery.
- Take rifampicin, carbamazepine, phenytoin or St John’s wort, which reduce its effect.
Expect follow-up, particularly if you are on it long term or as part of HRT — blood pressure, breast checks and a review of whether it is still needed.
Possible cautions and when to ask a pharmacist or doctor
Common effects are irregular bleeding or spotting, breast tenderness, bloating, headache, mood changes, nausea, weight change, acne and altered libido. Spotting is common in the first months.
Seek medical attention urgently if you develop:
- Pain, swelling, warmth or redness in a leg — possible deep vein thrombosis.
- Sudden breathlessness, chest pain or coughing blood — possible pulmonary embolism. Call emergency services.
- Sudden severe headache, visual disturbance, weakness or numbness on one side, or difficulty speaking — possible stroke.
- Yellowing of the eyes or skin, or severe abdominal pain.
- A new breast lump.
- New or worsening depression, or thoughts of self-harm.
- Severe migraine, or migraine with aura for the first time.
- Swelling of the face, lips or tongue, or a severe rash.
See a doctor rather than continuing if:
- Bleeding is heavy, prolonged or unpredictable despite treatment.
- You have bleeding after menopause, or bleeding after sex — these always need investigation.
- You have pelvic pain that is new or worsening.
- Periods do not return as expected after stopping.
- You might be pregnant.
- You are using it long term without review.
Bleeding is a symptom, not a diagnosis. Where Provera is prescribed for abnormal bleeding, it should follow an assessment rather than replace one.
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Frequently asked questions
What are Provera tablets used for? Irregular, absent or heavy periods, abnormal uterine bleeding, endometriosis, and as the progestogen part of HRT. It contains medroxyprogesterone.
What is Provera 5 mg used for? A common gynaecological strength, used to regulate the cycle, induce a withdrawal bleed, or manage heavy bleeding.
What is Provera 10 mg used for? The same purposes at a higher strength, often for inducing a period or for heavier bleeding.
Is Provera a contraceptive? No. Provera tablets do not prevent pregnancy. Depo-Provera, the injection, is a contraceptive — they are different products.
Will it bring on my period? Taken for a set number of days and then stopped, the withdrawal usually triggers a bleed within a few days. Your doctor sets the schedule.
Can I take it in pregnancy? No. Pregnancy should be excluded before starting.
Why is it given with oestrogen in HRT? Oestrogen alone thickens the womb lining and raises the risk of endometrial cancer. A progestogen protects against that.
Does it cause weight gain? Weight change, bloating and fluid retention are reported. Mention it to your doctor if it becomes a problem.