Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Progestins and estrogens are the two major
classes of female hormones. Medroxyprogesterone is a derivative of the naturally
occurring female progestin, progesterone. Progestins are responsible for changes
in the mucus and inner lining of the uterus (endometrium) during the second half
(secretory phase) of the
menstrual cycle. Progestins prepare the endometrium for
implantation of the embryo. Once an embryo implants in the endometrium, for
example,
pregnancy occurs, progestins help maintain the pregnancy. At high doses,
progestins can prevent ovulation (release of the egg from the ovary) and thereby
prevent pregnancy. Progestins were first isolated in 1933, and progesterone
itself was synthesized in the 1940s.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 2.5, 5, and 10 mg. Intramuscular injection:
150, 160, and 400 mg/ml.
STORAGE: Medroxyprogesterone should be stored at room temperature,
between 20-25 C (68-77 F).
PRESCRIBED FOR: Medroxyprogesterone tablets are used for treating
secondary amenorrhea (cessation of menstruation);
abnormal bleeding from the
uterus due to hormonal imbalance and not due to
fibroids, or
cancer; and to
prevent endometrial hyperplasia (overgrowth in the endometrial lining) in
postmenopausal women who have not undergone a hysterectomy and are receiving
conjugated estrogens. Medroxyprogesterone injection is used for contraception
and for treating endometrial or renal cancer.
DOSING: The usual dose of medroxyprogesterone tablets is 5 or 10 mg
daily. Secondary amenorrhea is treated for 5 to 10 days. Uterine bleeding is
treated for 5 to 10 days beginning on day 16 or 21 of the menstrual cycle.
Endometrial hyperplasia is treated for 12 to 14 consecutive days beginning on
day 1 or 16 of the menstrual cycle.
The dose for contraception is 150 mg every 3 months injected intramuscularly
or 104 mg injected subcutaneously every 3 months. The dose for endometrial or
renal cancer is 400-1000 mg weekly initially followed by monthly maintenance
doses.
DRUG INTERACTIONS:Aminoglutethimide
(Cytadren) may increase the elimination of
medroxyprogesterone by the liver leading to a decrease in the concentration of
medroxyprogesterone in blood and possibly a reduction in the effectiveness of
the medroxyprogesterone.
PREGNANCY: Medroxyprogesterone inhibits fertility at high doses. It
should not be given during pregnancy.
NURSING MOTHERS: Medroxyprogesterone is secreted in
breast milk. The
effect on the infant has not been determined.
SIDE EFFECTS: Breast tenderness and leakage of liquid from the nipple
occur rarely with medroxyprogesterone. Various skin reactions, including
hives,
acne, hair growth and hair loss, also have been reported occasionally.
Break-through bleeding (menstrual-like bleeding in the middle of the menstrual
cycle), vaginal spotting of blood, changes in menstrual flow, increased or
decreased weight, nausea, fever, insomnia, and jaundice have all been reported.
Endometriosis is the growth of cells similar to those that form the inside of the uterus, but in a location outside of the uterus. Endometriosis implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder. Treatment of endometriosis can be with medication or surgery.
Though uterine cancer's cause is unknown, there are many factors that will put a woman at risk, including: over age 50, endometrial hyperplasia, using hormone replacement therapy, obesity, using tamoxifen, being Caucasian, having colorectal cancer. Symptoms of cancer of the uterus (endometrial cancer) include abnormal vaginal bleeding, painful urination, painful intercourse, and pelvic pain. Treatment depends on staging and may include radiation therapy or hormone therapy.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the “change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
Normal vaginal bleeding (menorrhea) occurs through the process of menstruation. Abnormal vaginal bleeding in women who are ovulating regularly most commonly involves excessive, frequent, irregular, or decreased bleeding. Causes of abnormal may arise from a variety of conditions.
Learn about osteoporosis, a condition characterized by the loss of bone density, which leads to an increased risk of bone fracture. Unless one experiences a fracture, a person may have osteoporosis for decades without knowing it. Treatment for osteoporosis may involve medications that stop bone loss and increase bone strength and bone formation, as well as quitting smoking, regular exercise, cutting back on alcohol intake, and eating a calcium- and vitamin D-rich balanced diet.
Hot flashes (or flushing) is the most common symptom experienced by a woman prior to and during the early stages of menopause. Hot flashes can be caused by other conditions. Diagnosis is made by taking a patient history and at times, blood tests. Treatment options include hormone therapy, bioidentical hormone therapy, and medications. There are non-FDA approved natural remedies.
Menstruation (menstrual cycle) is also referred to as a "period." When a woman menstruates, the lining of the uterus is shed. This shedding of the uterine linking is the menstrual blood flow. The average menstrual cycle is 28 days. There can be problems with a woman's period, including heavy bleeding, pain, or skipped periods. Causes of these problems may be amenorrhea (lack fo a period), menstrual cramps (dysmenorrhea), or abnormal vaginal or uterine bleeding. There are a variety of situations in which a girl or woman should see a doctor about her menstrual cycle.
Pregnancy planning is important to help prevent exposure of the mother and fetus to potentially harmful medications and substances during the early days, and throughout the pregnancy. Nutritional planning, prevention of birth defects, conditions such as high blood pressure, heart disease, diabetes, and kidney disease need careful monitoring. Gestational diabetes, preeclampsia, and pregnancy induced hypertension are conditions that may arise during pregnancy. Immunizations, inherited disorders, exercise, air travel, intercourse, and birth control are important factors to consider when planning a pregnancy.
There are a number of different methods of birth control to include: barrier methods, IUDs, hormonal methods, natural methods, and surgical sterilization. Birth control methods can be reversible or permanent. In simple terms, all methods of birth control are based on either preventing a man's sperm from reaching and entering a woman's egg (fertilization) or preventing the fertilized egg from implanting in the woman's uterus (her womb) and starting to grow.
If a woman is sexually active and she is fertile — physically able to become
pregnant — she needs to ask herself, "Do I want to become pregnant now?" If her
answer is "No," she must use some method of birth control (contraception).
If a woman does not want to get pregnant at this point in her life, does she
plan to become pregnant in the future? Soon? Much later? Never? Her answers to these
questions can determine the method of birth control that she and her male sexual
partner use — now and in the future.
There are a number of different ways to describe birth control. Terms include
contraception, pregnancy prevention, fertility control, and family planning. But
no matter what the process is called, sexually active people can choose from a
plethora of methods to reduce the possibility of their becoming pregnant.
Nevertheless, no method of birth control av...
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