Medroxyprogesterone acetate (Provera): its role in menopause HRT

• What it is: a synthetic progestogen (a progestin), not identical to your own progesterone.
• Brand in PH: Provera.
• Rx status: prescription only.
• Form sold: 10 mg tablet, ₱96.50 per tablet (Watsons). We did not find lower strengths listed at Watsons.
• Used with: an estrogen such as estradiol gel or conjugated estrogens, only if you have a uterus.
• Other uses: doctors also use MPA for some period problems outside menopause. That is not covered here.

Prices checked October 2026. See the HRT cost calculator for monthly examples.

Estrogen on its own can make the womb lining (endometrium) grow too thick, which raises the risk of endometrial cancer. Adding a progestogen prevents that. That is why the US FDA kept the endometrial cancer boxed warning for systemic estrogen-alone products when it removed other HRT boxed warnings in November 2025 (RAPS).

There are two common patterns, both set by your doctor:

• Sequential: estrogen every day, MPA for part of each month. You usually get a monthly bleed.
• Continuous: estrogen and a smaller dose of MPA every day, usually once periods have stopped for a while. The aim is no bleeding. (The WHI combined trial used 2.5 mg MPA daily with 0.625 mg conjugated estrogens.)

The US Provera label lists 5 or 10 mg daily for 12 to 14 consecutive days a month alongside daily estrogen, starting at the lowest dose. It does not list a continuous regimen; if you take MPA every day, your doctor sets that dose. Check the leaflet in your PH pack too.

A bit of history: MPA was the progestogen in the big Women's Health Initiative (WHI) combined trial, paired with conjugated estrogens (Rossouw et al., JAMA 2002). Much of the old fear about HRT and breast cancer comes from that combination. A large French observational study (E3N) found no clear rise in breast cancer risk with estrogen plus micronized progesterone or dydrogesterone, but a higher risk with estrogen plus other synthetic progestins. That is observational data, not a trial, so it suggests rather than proves a difference. Read Nakaka-cancer ba ang HRT? for the numbers.

The US Provera label says not to use it if you have:

• Pregnancy, or possible pregnancy
• Vaginal bleeding that has not been checked
• Current or past breast cancer, or another hormone-sensitive cancer
• A current or past blood clot, stroke or heart attack
• Liver disease
• A past severe allergic reaction to Provera

The leaflet in your PH pack may word these differently.

If you are still having periods and could get pregnant, HRT is not contraception. See birthcontrolphilippines.com for options in your 40s.

Side effects listed on the US Provera label include breast tenderness, breakthrough bleeding or spotting, headache, nervousness, low mood, bloating, swelling and weight gain. If mood side effects are strong, tell your doctor; switching progestogen sometimes helps.

Irregular bleeding in the first months of continuous HRT can be expected. Bleeding that starts after a long bleed-free stretch, or bleeding after menopause when you are not on HRT, needs a check. See bleeding after menopause.

Prices checked October 2026. The number of tablets per month depends on your regimen, so compare real monthly costs on the cost calculator.

All of these can protect the womb lining. MPA is often the choice when an older regimen is already working well, or for cost and availability.

• Why MPA for me rather than micronized progesterone or dydrogesterone?
• Sequential or continuous: which suits where I am in menopause?
• What bleeding pattern should I expect, and what bleeding is not normal?
• If I get low mood or bloating, can we switch?
• How often should we review my HRT?

Other progestogens sold in the PH:

• Micronized progesterone (Utrogestan): identical to your own progesterone.
• Dydrogesterone (Duphaston): a progestogen close to natural progesterone.
• Tibolone: a single tablet that does the job of estrogen and progestogen together.

Compare prices on HRT costs, and read HRT for menopause for how regimens are built. To discuss a switch, find a doctor.