Depo-subQ Provera 104 (medroxyprogesterone) is a long-acting contraceptive injection developed by Pfizer and approved by the U.S. Food and Drug Administration (FDA) to treat pain in endometriosis. The medication is injected every 12 to 14 weeks. Depo-subQ Provera 104 is similar to Depo-Provera (medroxyprogesterone acetate), but contains a lower dosage of medroxyprogesterone.

What is endometriosis?

Endometriosis is a disease affecting the female reproductive organs. Endometrial tissue (the tissue that lines the uterus) begins to grow in patches or lesions outside of the uterus. These lesions swell and shed with the menstrual cycle, but being located outside of the uterus, the tissue cannot be expelled, causing pain and inflammation. The lesions usually occur in the abdominal cavity, but also may be found in other areas.

The menstrual cycle is controlled by a delicate balance of hormones that regulate the release of an egg or ovum from the ovaries each month, the preparation of the uterus to receive the ovum following fertilization, and the release of both egg and endometrium if fertilization does not occur. Estrogen is a hormone that is central to this process; many hormonal treatments for endometriosis are targeted at reducing estrogen levels.

How Depo-subQ Provera 104 works

Medroxyprogesterone is an artificial progestin, a hormone that binds to the progesterone receptor, which is present in the female reproductive tract, mammary glands, and a region of the brain called the hypothalamus. Once bound to the progestin receptor, medroxyprogesterone slows the release of gonadotropin-releasing hormone (GnRH), the hormone that controls the release of estrogen from the ovaries.

When estrogen levels are lowered, the endometrial lesions do not swell or shed because the menstrual cycle is blunted or stopped altogether.

Depo-subQ Provera 104 in clinical trials for endometriosis 

Two clinical trials have tested the effectiveness of depo-subQ Provera 104 in reducing endometriosis-associated pain in women with symptoms of endometriosis. Both studies assessed pain reduction over six months and whether symptoms reoccurred one year after treatment.

The first study was conducted in the U.S. and Canada. A total of 136 patients were treated with Depo-subQ Provera 104 for six months, receiving an injection every three months. Another 138 women were treated with Lupron Depot, a GnRH receptor agonist, for six months, receiving a dose of either 11.25 mg every three months or 3.75 mg every month.

The second study was conducted in South America, Europe, and Asia. The Depo-subQ Provera 104  treatment group contained 153 patients, while 146 patients received Lupron Depot.

Both studies showed a significant improvement in pain with treatment (either Lupron Depot or Depo-subQ Provera 104), but patients treated with Depo-subQ Provera 104 had significantly less decline in bone mineral density, and lower incidence and severity of menopausal symptoms (such as hot flashes) compared to women treated with Lupron Depot.

Other information

Depo-subQ Provera 104 may cause side effects including abdominal pain, nausea, swelling or tenderness in the breasts, headache, and diarrhea.

Depo-subQ Provera 104 also may cause bone loss, which may be irreversible.


Endometriosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Endometriosis News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to endometriosis.