Medroxyprogesterone for Menopause: What It Treats, What It Doesn't, and What the Label Says in 2026

Medroxyprogesterone at a glance

Who this page is for — and who should stop reading and call someone

What we actually verified for this page

We didn't summarize other articles. Here's exactly what we read, and when.

• The current FDA prescribing information for Provera, on DailyMed. The label content is marked Revised March 2024. The label file was republished on June 30, 2026— four and a half months after the FDA's February labeling action.
• The FDA's own tracking page listing which menopause hormone products have had their prescribing information updated. Checked 9 July 2026. Page content still stamped “current as of 02/12/2026.”
• The Women's Health Initiative risk numbers— taken directly out of Provera's label, not from news coverage of it.
• The endometrial-protection trial datasubmitted to the FDA and printed inside Provera's label. Most people have never seen these tables.
• Cash prices at GoodRx, SingleCare, and Drugs.com, all checked on 9 July 2026, recorded by strength and quantity.
• The public medication and formulary pages of the five providers on our review roster, to find out which ones actually prescribe medroxyprogesterone.

1. What is medroxyprogesterone for menopause, and what does it do?

Medroxyprogesterone acetate is a synthetic progestin — a lab-made hormone that acts on the same receptors as the progesterone your ovaries used to make. In menopause care, the FDA approves it for one purpose: preventing endometrial hyperplasia in nonhysterectomized postmenopausal women who are receiving daily oral conjugated estrogens 0.625 mg. It is also approved for two conditions unrelated to menopause: secondary amenorrhea and abnormal uterine bleeding.

Here's where the confusion starts. The word “progesterone” gets used loosely — by websites, by pharmacists, and sometimes by doctors. But these are genuinely different products with genuinely different labels.

The name decoder

Sources: Provera label · Prempro/Premphase label · Prometrium label · FDA on compounding

Provera is not Depo-Provera. This matters more than you'd think.

Same molecule. Same brand family. Completely different products, and women land on the wrong information constantly.

If you were handed a tablet you take for part of the month, you're in the Provera column. If you get a shotevery three months, that's contraception, and this page isn't about your medication.

The distinction became more important recently. In December 2025, the FDA approved a label change adding a meningioma warning to both injectable forms — Depo-Provera CI and Depo-SubQ Provera 104 — after studies linked long-term use to this usually benign tumor in the lining of the brain. The injectables are now contraindicated in anyone with a meningioma or a history of one. This is a Warning, not a boxed warning; the boxed warning on the injectables concerns bone mineral density loss with long-term use.

Why medroxyprogesterone is “synthetic” and progesterone isn't

Micronized progesterone is structurally identical to what your ovaries produced. Medroxyprogesterone is a modified molecule — chemically altered, patented, studied for decades.

“Synthetic” is not a synonym for “dangerous.” It's a chemistry word. But it has become a marketing word, and that's most of why you're on this page feeling uneasy. Hold that thought.

2. Why is medroxyprogesterone taken with estrogen instead of on its own?

Estrogen taken without a progestogen thickens the lining of the uterus, and over time that raises the risk of endometrial cancer. Medroxyprogesterone's job is to stop that. In the three-year trial submitted to the FDA, 12% of women taking estrogen alone developed atypical endometrial cells — the kind that can turn into cancer. Among women who added medroxyprogesterone, none did.

That number is sitting inside Provera's own prescribing information, and almost no consumer page has ever printed it. Here it is.

What Provera's label actually shows

Three-year, double-blind, placebo-controlled trial. 356 nonhysterectomized postmenopausal women, ages 45–64. Endometrial biopsy results at 3 years.

A second trial in the same label. One year, 832 postmenopausal women. Cystic hyperplasia occurred in 55 women (19%) on estrogen alone. It occurred in 3 women (1%) who added medroxyprogesterone 5 mg, and zerowho added 10 mg.

And in the PEPI trial — a three-year randomized study of 875 women published in JAMA — unopposed estrogen produced adenomatous or atypical hyperplasia in 34% of women, compared with 1% across every arm that included a progestogen.

3. The Women's Health Initiative numbers — from the actual label

In the Women's Health Initiative, estrogen plus medroxyprogesterone was associated with a relative risk of 1.24 for invasive breast cancer — 41 cases versus 33 per 10,000 woman-years. In absolute terms, The Menopause Society estimates fewer than one additional case per 1,000 women per year of use. Among women who had never previously used hormone therapy, the relative risk was 1.09 and was not statistically significant.

We're printing both of those sentences because Provera's label reports the dementia risk figure two different ways in two different sections — the WARNINGS section gives raw counts (40 vs 21 cases in 4,532 women over roughly four years) while the CLINICAL STUDIES section gives different figures entirely. We noticed. We show you both rather than picking one, because picking one would be exactly the kind of thing this page is supposed to prevent.

Source: Provera prescribing information, CLINICAL STUDIES section. WHI study population average age: 63.2 years, more than a decade past average menopause onset. These numbers have been contested as not representative of younger perimenopausal women initiating therapy. That is the FDA's own stated rationale for the February 2026 labeling review.

Note what that table also shows: HRT reduced colorectal cancer by 37%, hip fractures by 34%, and total mortality was essentially identical. The WHI is not a clean indictment of medroxyprogesterone — it is a large, complicated study of a specific population that may not look like you.

4. The February 2026 FDA label update — what changed, and what didn't

On February 12, 2026, the FDA approved new prescribing information for six menopause hormone therapy products, removing the scary boxed warning language about heart disease, breast cancer, and probable dementia. Prometrium was in that first batch. Provera was not. Provera's label, republished on June 30, 2026, still carries the full boxed warning.

Here's what we can actually verify about why the gap exists, without overstating it:

1. The FDA's November 2025 request was class-wide.It explicitly covered all four categories of menopause hormone therapy, including “systemic progestogen-alone therapy for women with a uterus using systemic estrogen.” Medroxyprogesterone products are squarely inside that scope.
2. The FDA called these six “the first batch.” Twenty-nine drug companies filed proposed labeling changes. Approvals are being processed application by application, company by company.
3. The FDA has said nothing about medroxyprogesterone being riskier. It has also said nothing about it being safer. It has said nothing at all, yet.

What informed clinicians said about the change

Two menopause physicians went on record with Healioabout the February 2026 announcement, and they didn't agree.

Dr. Holly Thacker, who directs the Cleveland Clinic Center for Specialized Women's Health, welcomed it and said it lines up with the published research. She said she hopes it reduces the exaggerated fear that kept many women from treatment and many clinicians from prescribing.

Dr. Nanette Santoro, professor of obstetrics and gynecology at the University of Colorado School of Medicine, was more skeptical. She said she was surprised transdermal estradiol wasn't in the first batch. She was also surprised that the label for estrogen plus progestin no longer mentions increased clotting risk, and questioned what data supported that omission.

Both of those things can be true. The old warnings were overstated. And the new labels aren't perfect. Anyone selling you certainty in either direction is selling.

5. Does medroxyprogesterone help hot flashes and night sweats?

Medroxyprogesterone is not FDA-approved to treat hot flashes. If your hot flashes have improved on hormone therapy, the estrogen is doing that work. Progestogens taken alone for hot flashes are used off-label. Older studies do show medroxyprogesterone reduces hot flashes, but most were small, several were in people undergoing cancer treatment, and The Menopause Society notes there are no long-term results.

What the evidence really shows:

• Combination products are different. Prempro and Premphase — conjugated estrogens plus medroxyprogesterone in one tablet — are FDA-approved for menopause symptoms including hot flashes. The estrogen is why. The medroxyprogesterone is there to protect your uterus.
• Progestogen alone for hot flashes is off-label. The Menopause Society is direct: synthetic progestins have shown benefit for vasomotor symptoms in some studies, but no long-term results exist, and using a progestogen without estrogen for hot flashes is off-label.
• The best progestogen-alone evidence is for micronized progesterone at 300 mg nightly, which significantly reduced hot flashes and night sweats versus placebo and improved sleep. That evidence is still limited and short-term.
• Injectable depot medroxyprogesterone works, in a narrow context. Older studies showed substantial hot-flash reduction — but largely in cancer-treatment populations, and that is not how menopause care is delivered.

If hot flashes are your main problem, the medication you should be reading about is estradiol — or, if hormones aren't right for you, a non-hormonal option like Veozah (fezolinetant) or Lynkuet (elinzanetant). See our non-hormonal menopause treatment options.

6. Medroxyprogesterone vs. micronized progesterone: should you ask to switch?

On breast cancer signal, micronized progesterone currently looks more favorable: a large French cohort study found no increased risk with estrogen plus progesterone, compared with a 69% relative increase for estrogen plus other progestogens. On endometrial protection, the one randomized head-to-head trial found them equally effective. On cost, generic medroxyprogesterone is typically the cheaper of the two. No randomized trial has compared them with cancer as the endpoint, so a confident verdict in either direction goes past the evidence.

The decision matrix

Where micronized progesterone looks better. Say it out loud.

The E3N study followed 80,377 postmenopausal French women and recorded 2,354 invasive breast cancers over a mean 8.1 postmenopausal years. Compared with women who never used hormone therapy:

• estrogen + progesterone: relative risk 1.00 (0.83–1.22)
• estrogen + dydrogesterone: relative risk 1.16 (0.94–1.43)
• estrogen + other progestogens (the category MPA falls into): relative risk 1.69 (1.50–1.91)

This is observational data, not a randomized trial. It cannot prove causation. It is also the best comparative evidence anyone has.

The PEPI trial — randomized, 875 women, three years — found that estrogen combined with cyclic micronized progesterone preserved HDL cholesterol significantly better than estrogen with either medroxyprogesterone regimen. And laboratory work from the Karolinska Institute found micronized progesterone does not increase breast cell proliferation the way medroxyprogesterone does.

But here's what happens becausemedroxyprogesterone skips the things that make micronized progesterone what it is: it isn't suspended in peanut oil. It doesn't sedate you, so you're not locked into bedtime dosing. It costs meaningfully less. And its endometrial protection is the most thoroughly documented of any progestogen on a US label — a 12-percentage-point drop in precancerous cells, in the manufacturer's own submitted trial.

The counterweight nobody publishes

Observational data have raised the possibility that micronized progesterone may protect the endometrium less effectively than synthetic progestins in continuous daily regimens — the opposite direction from the breast finding. The researchers behind the ongoing Swedish PROBES trial say exactly that in their published protocol. PROBES compares micronized progesterone against norethisterone acetate — not medroxyprogesterone — and will not settle the MPA-vs-progesterone question directly. Nothing currently running will.

Probably better for the breast, possibly weaker for the uterus, and no trial on the horizon that directly compares your two options. Anyone giving you a clean verdict right now is guessing.

If you're X, here's the conversation to have

7. How much medroxyprogesterone do you take, and for how many days?

The FDA label describes 5 mg or 10 mg daily, taken for 12 to 14 consecutive days per month, in postmenopausal women receiving daily conjugated estrogens 0.625 mg — beginning either on day 1 or day 16 of the cycle. The label instructs prescribers to start patients at the lowest dose, use the shortest duration consistent with treatment goals, and reevaluate every three to six months.

There's a line in Provera's label that we have never seen quoted on a consumer website:

“The lowest effective dose of PROVERA has not been determined.”

That sentence does a lot of work. It means the 5-versus-10 mg decision isn't settled science — it's clinical judgment about your body. Which makes it a fair question to ask.

Translating what's on your bottle

Do not use this table to change your own dose. It exists so you can understand what you were handed and ask a sharper question about it.

Cyclic vs. continuous dosing

Cyclic:you take medroxyprogesterone for 12–14 days each month alongside daily estrogen. This often causes monthly withdrawal bleeding, which some women find reassuring as evidence the endometrium is shedding. It's most appropriate for recently menopausal women.

Continuous: found in combination products like Prempro — estrogen plus a lower dose of MPA taken every day. No withdrawal bleeding is expected, though irregular spotting is common in the first year. More common for women who are further past menopause.

Your prescriber chooses based on your history, how long you've been menopausal, and your preference for bleeding pattern. Neither is universally better.

8. Side effects and tolerance: what the label actually lists

Provera's label lists: mental depression, insomnia, somnolence, dizziness, nervousness, headache, nausea, bloating, change in weight (increase or decrease), and fluid retention. Unlike micronized progesterone, it does not require bedtime dosing and does not cause the GABA-related sedation that makes progesterone a sleep medication for some women.

Key tolerability notes from the label:

• Mood changes are documented. Mental depression, nervousness, and insomnia are all listed. If your mood shifts after starting medroxyprogesterone, that is a reason to report it and discuss a different progestogen — not a reason to quietly suffer.
• Weight is not predictable.The label lists “change in weight (increase or decrease)” — both directions. How common and how significant this is remains genuinely mixed in the evidence.
• No bedtime-dosing requirement. Unlike progesterone capsules, medroxyprogesterone does not cause GABA-related sedation. You can take it morning or evening.
• Androgenic effects noted.The label explicitly states androgenic and anabolic effects have been noted. Progesterone's label does not. This difference in label language is one reason some prescribers prefer the latter.

If you're tolerating medroxyprogesterone well and your uterine protection is confirmed, there is no clinical reason to switch on tolerability grounds alone. If you're not tolerating it, that's a reason to ask — see the conversation table in Section 6.

9. What does medroxyprogesterone cost in 2026?

Generic medroxyprogesterone is consistently the least expensive FDA-approved progestogen option. At our July 9, 2026 check, GoodRx listed generic medroxyprogesterone from $5.20 against an average retail price of $33.26. Brand-name Provera retails substantially higher. The spread across pharmacies for the same generic is often larger than the price difference between drugs.

Ask for the cash price even if you have insurance. On drugs this inexpensive, the GoodRx or SingleCare discount card price frequently beats the insurance copay. See can you use an HSA for HRT? for help with FSA/HSA coverage.

Compare per-cycle cost, not per-bottle.A cyclic regimen (12–14 days/month at 5 or 10 mg) uses far fewer tablets than a continuous daily regimen. A 30-tablet bottle may last two or three months on a cyclic schedule. Your pharmacy prices by the bottle — you should price by the cycle.

10. Which online providers prescribe medroxyprogesterone?

Across the five menopause telehealth providers on our review roster, micronized progesterone is the default progestogen and medroxyprogesterone barely appears at all. Sesame is the only provider on our roster with a dedicated medroxyprogesterone service — a fact we verified and would publish regardless of any commercial relationship.

Watch for this on provider websites. Sesame's own medroxyprogesterone page lists hot-flash management, “as part of combined hormone therapy,” among the drug's uses in postmenopausal women on estrogen. Technically defensible. Practically misleading. The estrogen manages the hot flashes.We're pointing that out about a company we have an affiliate relationship with, because you're better served knowing it.

11. Progesterone shortage — and why medroxyprogesterone is still available

The FDA's February 2026 labeling change drove a surge in HRT prescriptions — Reuters reported progesterone-containing HRT prescriptions tripled since January 2021, with a 19% rise after the label change alone. That demand surge pushed certain oral progesterone capsule products from Amneal and Hikma into an ASHP-reported shortage. At our July 2026 check, we found no current shortage listing for medroxyprogesterone acetate tablets.

If you end up on medroxyprogesterone because progesterone isn't on the shelf, you have not been downgraded to a dangerous drug. You've been given a decades-old, FDA-approved medication that reduces uterine lining overgrowth by roughly the same margin. That is a perfectly reasonable place to be while the supply chain catches up.

Before you leave the pharmacy, ask: which manufacturer's generic do you stock, can you check a different manufacturer, and can you check a different strength? The estrogen patch shortage is a related concern — see estradiol patch shortage alternatives.

Frequently asked questions

Is medroxyprogesterone the same as Provera?

Yes. Provera is the brand name; medroxyprogesterone acetate is the drug. Generic medroxyprogesterone contains the same active ingredient and costs a fraction as much.

Is medroxyprogesterone FDA-approved?

Yes. Provera and generic medroxyprogesterone acetate tablets are FDA-approved prescription medications. That is different from compounded progesterone, which is not FDA-approved.

Did the FDA remove the boxed warning from Provera in 2026?

No. On 12 February 2026 the FDA approved boxed-warning changes for six products — Prometrium, Bijuva, Divigel, Cenestin, Enjuvia, and Estring. Provera and Prempro were not among them. The FDA called those six the first batch, and 29 companies have submitted proposed labeling changes. Provera's label, republished on 30 June 2026, still carries the full boxed warning.

Do I need medroxyprogesterone if I had a hysterectomy?

Generally no. The label states that a woman without a uterus does not need a progestin. Confirm with a clinician who knows your surgical history.

Can medroxyprogesterone help hot flashes?

It is not FDA-approved for hot flashes. Combination products containing both estrogen and medroxyprogesterone, like Prempro, are approved for menopause symptoms — but the estrogen is doing that work.

How many days a month do you take medroxyprogesterone with estrogen?

The label describes 5 mg or 10 mg daily for 12 to 14 consecutive days each month, alongside daily conjugated estrogens 0.625 mg. Continuous combination products are taken every day instead. Your clinician decides.

Does medroxyprogesterone cause breast cancer?

In the Women's Health Initiative, estrogen plus medroxyprogesterone was associated with more invasive breast cancer: 41 cases versus 33 per 10,000 woman-years, a relative risk of 1.24. Among women in that trial with no prior hormone therapy use, the relative risk was 1.09 and was not statistically significant. The Menopause Society estimates fewer than one additional case per 1,000 women per year of use.

Does medroxyprogesterone cause weight gain or bloating?

The label lists change in weight (increase or decrease) and fluid retention among possible effects. How common and how significant is genuinely mixed in the evidence.

Can medroxyprogesterone cause depression or anxiety?

Mental depression, insomnia, and nervousness are all listed on the label. If your mood shifts after starting it, report it. That is a reason to discuss a different progestogen, not a reason to quietly suffer.

What's the difference between medroxyprogesterone and Depo-Provera?

Same molecule, entirely different product. Depo-Provera is an injectable contraceptive given every 12 to 14 weeks. It carries a boxed warning about bone mineral density loss, and in December 2025 the FDA added a warning about meningioma to the injectable forms. Provera tablets are what's used in menopause hormone therapy, and they carry no meningioma warning.

Can I get medroxyprogesterone online?

It's prescription-only and never available over the counter. A licensed clinician can prescribe it through telehealth if appropriate. Most menopause platforms don't offer it; Sesame has a dedicated medroxyprogesterone service that sends the prescription to your own pharmacy.

Should I choose medroxyprogesterone or micronized progesterone?

That depends on your peanut allergy status, how you tolerate sedation, your cost constraints, your risk history, and what your clinician sees in your records. Observational data favor micronized progesterone on breast cancer signal. Randomized data show them equally protective for the uterus. No trial settles it.

Can I take estrogen without any progesterone?

Only if you don't have a uterus. Taking systemic estrogen alone with an intact uterus raises the risk of endometrial hyperplasia and endometrial cancer. This is the single most important rule on this page.

What is medroxyprogesterone 10 mg used for in menopause?

It's the higher of the two cyclic doses used for endometrial protection — 10 mg daily for 12 to 14 days a month, alongside estrogen. Provera's own label states that the lowest effective dose has not been determined, which makes 'why this dose for me?' a fair question.

Is compounded progesterone the same as medroxyprogesterone?

No, and it is important not to blur them. Medroxyprogesterone is an FDA-approved synthetic progestin. Compounded progesterone is prepared by a compounding pharmacy and is not FDA-approved. Different medications, different regulatory categories.