Who cannot take medroxyprogesterone? A Guide to Contraindications

October 9, 2025 •

3 min read

Injectable medroxyprogesterone acetate is a highly effective contraceptive, with a 99% efficacy rate. However, it is not a suitable option for everyone due to significant contraindications. Understanding who cannot take medroxyprogesterone is crucial for patient safety.

Quick Summary

This overview details the specific groups of people who should not use medroxyprogesterone. It covers absolute contraindications such as pregnancy, history of certain cancers, active liver disease, and thromboembolic disorders.

Key Points

Pregnancy: Medroxyprogesterone is absolutely contraindicated if you are pregnant or suspect you might be.
Blood Clot History: Individuals with a current or past history of thromboembolic disorders (blood clots, stroke) cannot take it.
Breast Cancer: A personal history of breast cancer or other hormone-sensitive cancers is a strict contraindication.
Liver Disease: People with significant liver disease or impaired liver function should not use this medication.
Undiagnosed Vaginal Bleeding: Use is contraindicated in cases of abnormal, undiagnosed vaginal bleeding.
Bone Density Loss: The injectable form carries a risk of significant bone mineral density loss, especially with use longer than two years.
Caution is Advised: Use with caution in individuals with a history of depression, diabetes, or conditions worsened by fluid retention.

What is Medroxyprogesterone?

Medroxyprogesterone is a synthetic progestin used for various medical purposes, including contraception (Depo-Provera), managing irregular periods, and as part of menopausal hormone therapy. While beneficial for many, its use is restricted in individuals with specific health conditions to avoid potential risks.

Absolute Contraindications: Who Cannot Take Medroxyprogesterone

There are certain conditions where medroxyprogesterone should never be used:

Pregnancy: It is contraindicated in those who are pregnant or suspect they are.
Blood Clot History: Individuals with a history of blood clots (like DVT, pulmonary embolism, stroke) should not use it. Injectable medroxyprogesterone is linked to an increased risk of venous thrombosis.
Breast Cancer: Those with current or past breast cancer should avoid hormonal contraceptives like medroxyprogesterone due to potential hormone sensitivity. There is a slightly increased risk of breast cancer, particularly in recent users under 35.
Other Hormone-Sensitive Cancers: Malignancies of the genital organs are also a contraindication.
Significant Liver Disease: As the liver metabolizes the drug, it is contraindicated in patients with significant liver issues, including impaired function or tumors. Jaundice requires discontinuation.
Undiagnosed Vaginal Bleeding: Abnormal bleeding not yet evaluated by a doctor is a contraindication as it could indicate a serious condition.
Known Hypersensitivity: Anyone allergic to medroxyprogesterone acetate or its components should not use it.

Relative Contraindications and Precautions

Some conditions require caution and close monitoring when using medroxyprogesterone:

Osteoporosis Risk: Injectable medroxyprogesterone can cause significant bone mineral density loss, especially with long-term use. Use with caution in those with osteoporosis risk factors.
Depression: Patients with a history of depression need close monitoring; re-administration is not advised if depression returns.
Diabetes: Medroxyprogesterone can affect glucose tolerance, requiring careful monitoring in diabetic patients.
Conditions Influenced by Fluid Retention: Progestational drugs can cause fluid retention, potentially worsening conditions like epilepsy, migraine, asthma, and heart or kidney issues.
Cardiovascular Risk Factors: Caution is advised for individuals with heart disease risk factors, particularly smokers.

Comparison of Key Contraindications


Condition	Status	Rationale
Pregnancy	Absolute Contraindication	Potential risk of birth defects and not indicated during pregnancy.
History of Blood Clots	Absolute Contraindication	Increased risk of serious thrombotic events like DVT, pulmonary embolism, and stroke.
Breast Cancer	Absolute Contraindication	Breast cancer may be hormone-sensitive, and the drug is linked to a slightly increased risk.
Significant Liver Disease	Absolute Contraindication	The drug is metabolized by the liver; impaired function can lead to altered drug levels and toxicity.
Osteoporosis Risk	Relative Contraindication/Caution	Use is associated with significant loss of bone mineral density, especially with long-term use.
History of Depression	Relative Contraindication/Caution	May exacerbate or cause recurrence of depression; requires careful monitoring.

Potential Drug Interactions

Some medications can interact with medroxyprogesterone, altering its effectiveness or that of other drugs. Examples include certain epilepsy medications, HIV treatments, and St. John's Wort, which can reduce medroxyprogesterone's efficacy. Medroxyprogesterone can also decrease the effectiveness of antidiabetic medications. Always inform your healthcare provider about all medications and supplements you are taking.

Conclusion

Medroxyprogesterone is a valuable medication but is not suitable for everyone. A thorough medical history review is essential before its use. Absolute contraindications include pregnancy, a history of blood clots, significant liver disease, and known or suspected hormone-sensitive cancers like breast cancer. Conditions like depression, diabetes, and osteoporosis risk factors require careful consideration and monitoring.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Consult with a healthcare professional for any health concerns or before making any decisions related to your health or treatment.

For more detailed information, you can consult the FDA's official drug label information.

Frequently Asked Questions

No, medroxyprogesterone is contraindicated in women who are known or suspected to be pregnant.

No. A current or past history of thromboembolic disorders, such as deep vein thrombosis or stroke, is an absolute contraindication for taking medroxyprogesterone.

You should not take medroxyprogesterone if you have significant liver disease or impaired liver function, as the drug is primarily metabolized by the liver.

No, women with a known or suspected history of breast cancer should not use medroxyprogesterone, as the cancer may be hormone-sensitive.

Yes, use of injectable medroxyprogesterone is associated with a significant loss of bone mineral density (BMD). It should not be used long-term (over 2 years) unless other methods are inadequate, and it should be used with caution in those with osteoporosis risk factors.

If you have diabetes, you should use medroxyprogesterone with caution. The medication can impair glucose tolerance, so careful monitoring by your doctor is required.

Undiagnosed vaginal bleeding is a contraindication. If you experience this, you should contact your healthcare provider immediately for evaluation to rule out any underlying serious conditions.