Eniva Vitamins, Minerals, Electrolyte Water, and Nutiritional Supplements Medroxyprogesterone

Medroxyprogesterone is a semisynthetic compound that differs in structure from the naturally occurring human hormone progesterone. It is added to estrogen replacement therapy to prevent uterine cancer caused by unopposed estrogen. It is also used to treat absence of menstrual bleeding (amenorrhea) and abnormal menstrual bleeding. Medroxyprogesterone is available alone and in a combination product. An injection product is used for contraception.

Interactions with Dietary Supplements

Vitamin A and folic acid
In a one-year study of predominantly malnourished women in India and Thailand, medroxyprogesterone used for contraception was associated with increased blood levels of vitamin A and folic acid.¹ The clinical meaning of these changes remains unclear.

Zinc and magnesium
In a group of 37 postmenopausal women treated with conjugated estrogens and medroxyprogesterone for 12 months, urinary zinc and magnesium loss was reduced in those women who began the study with signs of osteoporosis and elevated zinc and magnesium excretion.² The clinical significance of this interaction remains unclear.

Vitamin D
In a study of postmenopausal women, treatment with estrogen alone increased vitamin D blood levels, whereas estrogen plus medroxyprogesterone lowered vitamin D back to the level seen without estrogen use.³ This outcome might suggest that medroxyprogesterone interferes with beneficial effects estrogen may have on vitamin D metabolism and vitamin D supplementation would be called for. However, some research has not found the addition of vitamin D to estrogen/progestin combinations to be helpful.⁴ Therefore, while many doctors recommend 400 IU vitamin D to women taking estrogen/progestin combination hormone products, the efficacy of such supplementation has not been proven.

Summary of Interactions for Medroxyprogesterone

Depletion or interference	None known
Adverse interaction	None known
Side effect reduction/prevention	None known
Supportive interaction	None known
Reduced drug absorption/bioavailability	None known
Other (see text)	Folic acid Magnesium Vitamin A Vitamin D Zinc

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Joshi UM, Virkar KD, Amatayakul K, et al. Impact of hormonal contraceptives vis-a-vis non-hormonal factors on the vitamin status of malnourished women in India and Thailand. World Health Organization: Special Programme of Research, Development and Research Training in Human Reproduction. Task Force on Oral Contraceptives. Hum Nutr Clin Nutr 1986;40:205–20.

2. Herzberg M, Lusky A, Blonder J, Frenkel. The effect of estrogen replacement therapy on zinc in serum and urine. Obstet Gynecol 1996;87:1035–40.

3. Bikle DD, Halloran BP, Harris ST, Portale AA. Progestin antagonism of estrogen stimulated 1,25-dihydroxyvitamin D levels. J Clin Endocrinol Metab 1992;75:519–23.

4. Komulainen M, Tuppurainen MT, Kroger H, et al. Vitamin D and HRT: no benefit additional to that of HRT alone in prevention of bone loss in early postmenopausal women. A 2.5-year randomized placebo-controlled study. Osteoporosis Int 1997;7:126–32.

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The information presented in VitaminLore is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.