Medroxyprogesterone Acetate

Synthetic progestin similar to progesterone that is used in uterine bleeding, dysmenorrhea, infertility and contraception. For contraception is used as a single drug or in combination with estrogen. Daily oral administration or long-acting injection (intramuscular or subcutaneous) every 3 to 6 months.

It is excreted into breast milk in clinically non-significant amount ^{(Koetsawang 1982, Saxena 1977)} and no problems have been observed in infants whose mothers who were treated with this medication ^{(Singhal 2014, Díaz 1997, WHO 1994, Pardthaisong 1992, Zacharias 1986, Jiménez 1984, Dahlberg 1982, Karim 1971)}. Urinary medroxyprogesterone levels of these infants were undetectable. ^{(Virutamasen 1996)}

There may be increased prolactin and milk production in women who receive medroxyprogesterone. ^{(Omar 2006, Ratchanon 2000)}.There is no evidence of its effectiveness as a galactogogue. ^{(Zuppa 2010)}

Although it has not been shown effects on production and duration of breastfeeding when administered at any time postpartum ^{(Parker 2021, Phillips 2016, Singata 2016, Singhal 2014, Brownell 2013, Halderman 2002, Danli 2000, Hannon 1997, Karim 1971)}, it is still controversial on if it really decreases milk production when progestins are used before a fully establishment of breastfeeding has occurred. ^{(Brownell 2012, Rodriguez 2009)}

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During breastfeeding progestin-only contraceptives are preferable to those combined with estrogen and, in this case, those with a lower dose of estrogen. ^{(CDC 2016, 2013 y 2010, WHO/OMS 2015, Altshuler 2015, Berens 2015, CLM 2012, FFPRHC 2004, Moretti 2000, Guiloff 1974)}

For the first 4-6 weeks postpartum, non-hormonal methods are the first choice, followed by IUDs and progestogen implants. ^{(Berens 2015, Mwalwanda 2013, Rowe 2013, CLM 2012, Kaunitz 1998)}

American Academy of Pediatrics: medication usually compatible with breastfeeding.^{(AAP 2001)}

WHO List of Essential Medicines 2002: rates it as compatible with breastfeeding after the 6th postnatal week. ^{(WHO 2002)}

See below the information of this related product:

• Estradiol + Medroxyprogesterone (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)