Using Provera While Trying to Conceive: What You Need to Know

Provera is a prescription medication that contains medroxyprogesterone acetate, a synthetic progesterone. Progesterone is one of the hormones that control the menstrual cycle and ovulation (the release of an egg from the ovaries each month). It also helps prepare the lining of the uterus for pregnancy and sheds the lining each month (a process called menstruation) if pregnancy doesn’t occur.

Doctors may prescribe Provera to treat irregular menstrual periods. The drug may also be prescribed short-term to women who are trying to conceive using the fertility drug Clomid. However, long-term use of Provera may affect ovulation, pregnancy, and menstrual cycles. Here’s what you should know before taking the medication:

 

Why is Provera prescribed?

Provera is taken by mouth and is commonly used to treat a variety of disorders related to the menstrual cycle that are often caused by hormonal imbalances. These disorders include irregular or abnormal uterine bleeding, amenorrhea (the absence of menstruation), excessive bleeding, and endometriosis (a condition in which cells that normally line the uterus grow outside the uterus).

Additionally, for those who ovulate or menstruate infrequently, especially those trying to conceive, Provera may be prescribed to induce withdrawal bleeding or “menstrual flow,” explains Michelle  Hakaka, M.D., a Los Angeles-based obstetrician-gynecologist and coauthor of Expecting 411: Clear Answers and Smart Advice for Your Pregnancy . Provera can also delay menstruation, depending on an individual’s needs. 

 

Using Provera to stimulate ovulation

Doctors may prescribe Provera for women who are having trouble conceiving. The drug is often used in combination with Clomid (clomiphene citrate), a fertility drug used to treat infertility, says Amy Roskin, MD, an obstetrician-gynecologist at Seven Starling. Clomid is usually started on the third, fourth, or fifth day of the menstrual cycle.

So how does this mode work? Suppose someone with an irregular menstrual cycle wants to get pregnant. Typically, they would take Provera for 10 days, and then their period might resume 2-10 days later. This artificial menstrual cycle would help determine when to take Clomid to ensure ovulation, thus increasing the chances of conception.

But keep in mind that while Provera can help regulate your menstrual cycle, taking it long-term can also affect ovulation. “Provera is typically used short-term in specific circumstances (for example to induce menstruation) and is rare for ongoing use by women trying to conceive, as it can interfere with ovulation and thin the lining of the uterus, making it very difficult for a fertilized egg to implant,” says Dr Hakaka.

 

Can I take Provera while pregnant?

Provera’s side effects are similar to those of pregnancy, including nausea, vomiting, breast tenderness, and headaches. But if you become pregnant or are thinking about becoming pregnant while taking Provera, you should tell your healthcare provider right away because the drug is not recommended for use during pregnancy. “When you stop taking the medication, you will experience withdrawal bleeding,” says Danielle Roshan, MD, a board-certified obstetrician and associate professor specializing in high-risk fetal medicine at the New York University School of Medicine.

Provera is unlikely to cause miscarriage, so there’s no need to worry too much if you take it early in pregnancy. However, some studies have suggested a link between Provera and birth defects in babies exposed to it early in pregnancy, Dr. Roskin said. Provera is classified as a Category X drug by the U.S. Food and Drug Administration (FDA), which means it may cause birth defects or other risks to the fetus and is contraindicated for use during pregnancy.

 

Can Provera be used as a birth control?

Provera is often confused with a long-term injectable contraceptive called Depo-Provera, but these are not the same thing. In fact, although Provera can affect ovulation and reduce fertility, it does not prevent the release of an egg (ovulation), so doctors do not recommend taking Provera as a replacement for other birth control methods.

“Provera tablets should not be used as a contraceptive; they do not prevent ovulation or pregnancy,” says Dr. Roskin. “Depo-Provera is a stronger, longer-acting progestin injectable that is an effective form of birth control. Depo-Provera works by suppressing ovulation and preventing pregnancy.” Your healthcare provider can help you determine which of these medications is best for your individual symptoms.

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