Medroxyprogesterone is a semisynthetic compound that differs in structure from the naturally occurring human hormone progesterone. It is added to estrogen replacement therapy to prevent uterine cancer caused by unopposed estrogen. It is also used to treat absence of menstrual bleeding (amenorrhea) and abnormal menstrual bleeding. Medroxyprogesterone is available alone and in a combination product. An injection product is used for contraception.
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In a one-year study of predominantly malnourished women in India and Thailand, medroxyprogesterone used for contraception was associated with increased blood levels of vitamin A and folic acid.1 The clinical meaning of these changes remains unclear.
In a group of 37 postmenopausal women treated with conjugated estrogens and medroxyprogesterone for 12 months, urinary zinc and magnesium loss was reduced in those women who began the study with signs of osteoporosis and elevated zinc and magnesium excretion.2 The clinical significance of this interaction remains unclear.
In a one-year study of predominantly malnourished women in India and Thailand, medroxyprogesterone used for contraception was associated with increased blood levels of vitamin A and folic acid.3 The clinical meaning of these changes remains unclear.
In a study of postmenopausal women, treatment with estrogen alone increased vitamin D blood levels, whereas estrogen plus medroxyprogesterone lowered vitamin D back to the level seen without estrogen use.4 This outcome might suggest that medroxyprogesterone interferes with beneficial effects estrogen may have on vitamin D metabolism and vitamin D supplementation would be called for. However, some research has not found the addition of vitamin D to estrogen/progestin combinations to be helpful.5 Therefore, while many doctors recommend 400 IU vitamin D to women taking estrogen/progestin combination hormone products, the efficacy of such supplementation has not been proven.
In a group of 37 postmenopausal women treated with conjugated estrogens and medroxyprogesterone for 12 months, urinary zinc and magnesium loss was reduced in those women who began the study with signs of osteoporosis and elevated zinc and magnesium excretion.6 The clinical significance of this interaction remains unclear.
1. Joshi UM, Virkar KD, Amatayakul K, et al. Impact of hormonal contraceptives vis-a-vis non-hormonal factors on the vitamin status of malnourished women in India and Thailand. World Health Organization: Special Programme of Research, Development and Research Training in Human Reproduction. Task Force on Oral Contraceptives. Hum Nutr Clin Nutr 1986;40:205–20.
2. Herzberg M, Lusky A, Blonder J, Frenkel. The effect of estrogen replacement therapy on zinc in serum and urine. Obstet Gynecol 1996;87:1035–40.
3. Joshi UM, Virkar KD, Amatayakul K, et al. Impact of hormonal contraceptives vis-a-vis non-hormonal factors on the vitamin status of malnourished women in India and Thailand. World Health Organization: Special Programme of Research, Development and Research Training in Human Reproduction. Task Force on Oral Contraceptives. Hum Nutr Clin Nutr 1986;40:205–20.
4. Bikle DD, Halloran BP, Harris ST, Portale AA. Progestin antagonism of estrogen stimulated 1,25-dihydroxyvitamin D levels. J Clin Endocrinol Metab 1992;75:519–23.
5. Komulainen M, Tuppurainen MT, Kroger H, et al. Vitamin D and HRT: no benefit additional to that of HRT alone in prevention of bone loss in early postmenopausal women. A 2.5-year randomized placebo-controlled study. Osteoporosis Int 1997;7:126–32.
6. Herzberg M, Lusky A, Blonder J, Frenkel. The effect of estrogen replacement therapy on zinc in serum and urine. Obstet Gynecol 1996;87:1035–40.
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