PCOS-MEDICATION Messages for March, 2001: Re: PROVERA

Re: PROVERA

From: =?iso-8859-2?q?Zalányi Sámuel?= (anonymous@obgyn.net)
Fri, 16 Mar 2001 20:44:02 +0100 (MET DST)

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Maybe in reply to: MANDA: "PROVERA"

Hi, Here are copies of several letters posted earlier that answer your questions Sam (Ob/Gyn,RE)

Provera and the other progestins in use can bring about a bleeding only if the endometrium is prepeared by estrogens. If there is not enough estrogen, the endometrium does not develop thus there is no layer to be shed (menstruation). Prometrium (or Provera) only brings about a bleeding if your ovaries are producing the necessary amount of estrogens that build up the endometrium (inner layer of the uterus). Prometrium (or Provera) is only a means of inducing bleeding. What is your aim: only having regular cycles or ovulate/get pregnant? In these latter cases you have to go to the root of the problem and it is insulin resistance in most caeses of PCOS.

In biology (humans included) dosage does not work arithmetically but rather logaritmically. I.e. 200 or 300 mg does not make much of a difference. What makes is the estrogen effect exerted on the endometrium BFORE prometrium is taken. So the cause of the short, slight or no bleeding is that the endometrium has not had enough estrogen to build up and therefore there was not enough tissue to shed after prometrium was stopped. In fact a minimum of 6-8 days of prometrium (or provera) is enough to induce a bleeding, if the endometrium is suffciently primed, but usuall longer periods are suggested, to mimic the normal luteal phase.

Provera is medroxyprogesterone acetate. Progesterone is the main hormonal product of the corpus luteum, which forms after ovulation. Progesterone is responsible (among others) for the transformation of the endometrium (inner layer of the womb) in order to be able to accept a fertilized egg. If there is no ovulation, no corpus luteum and no progesterone is produced. This is the main reason why PCOS women do jot have regular periods or why they have irregular and/or prolonged bleeding sometimes. As provera is the close relative (chemically and biologically) of the natural progesterone, a course of 10-14 days of it brings about a near normal bleeding.

> Yes, I have been prescribed and have taken Provera to start
> my cycle, but it took a long time and it does have a lot of side
> effects. My regular MD gave them to me along with the birth control
> pill to start after the provera ran out. Neither one helped me
> either. This was a few years ago, and is one of the reasons I've
> avoided

> Renee
>
> At Tue, 13 Mar 2001, MANDA wrote:
> >
> >HAS ANYONE TAKEN PROVERA TO BRING ON AF AND HAVE IT NOT WORK?I WAS ON
> >PROVERA FOR 7 DAYS. IT HAS BEEN 18 DAYS SINCE MY LAST PILL AND STILL NO
> >AF.WHAT IS THE DOCTOR GOING TO DO NEXT? THE PROVERA MAKES ME SO MOODY,I
> >AM NOT SURE I WANT TO TAKE IT AGAIN UNLESS HE IS SURE IT IS GOING TO
> >WORK.

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Maybe in reply to: MANDA: "PROVERA"

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