Hormonal Therapy Selector
Select your preferences below to find the best hormonal therapy option for you.
Recommended Therapy:
When it comes to hormoneâbased treatments, Provera is a synthetic progestin containing medroxyprogesterone acetate. Itâs commonly prescribed for abnormal uterine bleeding, endometriosis, and as a contraceptive injection. Provera works by thickening cervical mucus and suppressing ovulation, offering a onceâdaily oral option or a monthly injection for those who prefer less frequent dosing.
But Provera isnât the only player in town. Below, weâll line up the most frequently mentioned alternatives-Norethindrone a lowâdose oral progestin, Levonorgestrel the active ingredient in a hormonal IUD and many pills, and Drospirenone a newer progestin used in combined oral contraceptives. By the end of this guide youâll know which option matches your health goals, lifestyle, and tolerance for side effects.
TL;DR
- Provera: oral or monthly injection; good for heavy bleeding & endometriosis; may cause weight gain.
- Norethindrone: lowâdose oral; ideal for shortâterm cycle regulation; milder sideâeffects.
- Levonorgestrel IUD: 3â5years of contraception; reduces menstrual flow dramatically; requires a clinician for placement.
- Drospirenone COC: combined pill; offers acne control & less water retention; risk of blood clots similar to other estrogenâcontaining pills.
- Choose based on frequency of dosing, need for contraception vs symptom control, and personal tolerance for hormonal fluctuations.
How to Choose the Right Hormonal Therapy
Before we dive into the sideâbyâside data, keep these four decision pillars in mind:
- Primary purpose - Are you looking for contraception, menstrual regulation, or treatment of a condition like endometriosis?
- Administration route - Oral tablet, injection, or intraâuterine device?
- Frequency & convenience - Daily pill vs quarterly injection vs multiâyear IUD.
- Sideâeffect profile - Weight changes, mood swings, bloodâclot risk, or boneâdensity impact.
Mark the pillar that matters most to you. That will narrow the field considerably.
SideâbyâSide Comparison
| Feature | Provera (Medroxyprogesterone) | Norethindrone | Levonorgestrel IUD | Drospirenone COC |
|---|---|---|---|---|
| Form | 10mg oral tablet or 150mg injectable | 5mg oral tablet | Intraâuterine system releasing 20”g/day | Combined oral pill (30”g ethinyl estradiol + 3mg drospirenone) |
| Primary Indications | Abnormal uterine bleeding, endometriosis, contraception (injectable) | Cycle regulation, secondary amenorrhea, contraception (offâlabel) | Longâterm contraception, heavy menstrual bleeding | Contraception, acne, PMS relief |
| Dosing Frequency | Once daily (oral) or every 12â14weeks (injectable) | Once daily for 10â14days each cycle | Inserted once; effective for 3â5years | One pill daily |
| Common Side Effects | Weight gain, bloating, mood changes, decreased bone density (longâterm injection) | Spotting, mild nausea, breast tenderness | Irregular bleeding first 3months, cramping at insertion | Headache, breast tenderness, slight increase in bloodâclot risk |
| Contraindications | Pregnancy, active breast cancer, uncontrolled hypertension | Known estrogenâdependent tumor (rare), liver disease | Uterine infection, unexplained vaginal bleeding | Smoking >15cig/day over age35, clotting disorders |
Deep Dive: Provera
Proveraâs oral version is typically prescribed at 5â10mg daily for 10â14days each month to treat heavy bleeding. The injectable form, often called DepoâProvera, is a 150mg dose given every 12â14weeks and is popular for people who want a âsetâandâforgetâ contraceptive.
Key advantages:
- Strong antiâproliferative effect on the uterine lining, which reduces menstrual blood loss.
- Effective for endometriosisârelated pain when used continuously.
- Injectable option eliminates daily pill fatigue.
Potential drawbacks:
- Longâterm injectable use can lower bone mineral density; a calciumârich diet and weightâbearing exercise are advised.
- Weight gain and fluid retention are reported in up to 15% of users.
- Irregular spotting is common during the first few cycles.
Alternative Spotlight: Norethindrone
Norethindrone is a lowâdose progestin taken for about 10â14days each month. Itâs often the first line for women who need a shortâterm âbreakthroughâ bleed control or who have mild endometriosis.
Pros include a milder sideâeffect profile and a quick onset of bleed reduction. However, it requires a strict monthly schedule, and its contraception efficacy is lower than that of dedicated progestinâonly pills.
Alternative Spotlight: Levonorgestrel (IUD)
Levonorgestrel delivered via a Tâshaped intraâuterine system provides up to 5years of contraception. The device releases a steady low dose of hormone directly into the uterine cavity, which dramatically thins the endometrial lining.
Why many choose it:
- Reduces menstrual flow by up to 90%-often eliminating periods altogether.
- Minimal systemic hormone exposure, so fewer systemic side effects.
- Onceâinâaâlifetime placement, great for busy lifestyles.
Drawbacks include the need for a clinician to insert and remove the device and possible cramping or spotting in the initial months.
Alternative Spotlight: DrospirenoneâBased Combined Oral Contraceptives
Drospirenone is a newer progestin that mimics natural progesterone and has antiâaldosterone activity, which helps reduce water retention and acne.
These pills are attractive for women who want both contraception and cosmetic benefits. Yet, they carry the same estrogenârelated clot risk as other combined pills, so smoking and clot history are red flags.
Choosing the Right Option: BestâFor Matrix
- Heavy menstrual bleeding + need for hormonal control: Provera oral or Levonorgestrel IUD.
- Shortâterm cycle regulation (10â14days a month): Norethindrone.
- Longâterm contraception with minimal bleeding: Levonorgestrel IUD.
- Concurrent acne or premenstrual mood symptoms: Drospirenone COC.
- Preference for quarterly visits rather than daily pills: Provera injectable.
Quick Decision Checklist
- Is contraception your primary goal? If yes, prioritize IUD or combined pills.
- Do you need symptom relief for endometriosis or heavy bleeding? Provera oral or injectable is strongest.
- Can you commit to a clinician visit for insertion? Choose Levonorgestrel IUD.
- Are you concerned about weight gain or bone health? Lean toward Norethindrone or IUD.
- Do you smoke or have clotting risk? Avoid Drospirenone COC and estrogenâcontaining combos.
Frequently Asked Questions
Can Provera be used as a contraceptive?
Yes. The 150mg injectable form (often called DepoâProvera) provides contraception for about 12â14weeks. It works by suppressing ovulation and thickening cervical mucus.
How does the levonorgestrel IUD compare to daily pills in terms of side effects?
Because the hormone is released locally in the uterus, systemic side effects like nausea, breast tenderness, or mood swings are far less common than with oral contraceptives.
Is weight gain inevitable with Provera?
Not everyone gains weight, but fluid retention and increased appetite are reported in a minority of users. Lifestyle changes can mitigate the effect.
Can I switch from Provera to an IUD without a washâout period?
Generally, a short overlap is safe. Your clinician may schedule the IUD insertion at the end of your Provera injection cycle to avoid a gap in protection.
Which option is best for a woman in her early 30s with a history of migraines?
A progestinâonly method such as the levonorgestrel IUD or norethindrone can be safer, as estrogenâcontaining pills can worsen migraine frequency.
Paul Baker
Provera got me through my crazy bleeding but damn did I gain 15lbs đ© I switched to the IUD and my period is basically gone now. No more daily pills. Life changed.
Zack Harmon
THIS IS WHY AMERICA IS FALLING APART. PEOPLE ARE TAKING HORMONES LIKE CANDY. YOU WANT TO STOP YOUR PERIOD? JUST STOP BEING A WEAKLING. I NEVER TOOK ANYTHING AND IâM FINE.
Jeremy S.
I went from Provera to the IUD. Biggest win. No more mood swings, no more bloating. Just peace. If youâre on the fence, try the IUD. Itâs not scary once you get past the initial fear.
Jill Ann Hays
The pharmacological profile of medroxyprogesterone acetate demonstrates a significant affinity for progesterone receptors with minimal androgenic activity however the systemic absorption of depot formulations may induce measurable bone mineral density reduction over time which necessitates clinical monitoring
Mike Rothschild
If youâre struggling with heavy bleeding and hate daily pills the IUD is the real MVP. Iâve had mine for 4 years. No more calendar tracking. No more panic when I forget a pill. Just live your life.
Ron Prince
Provera? More like Prove-hera. Only for weak people who canât handle their own body. Real men donât take hormones. Real women just deal with it. Also I heard the IUD causes cancer now.
Sarah McCabe
Iâm from Ireland and we donât talk about this stuff much but I tried the IUD after years of Provera and it was like a miracle. No more pain. No more anxiety. Just chill vibes đż
King Splinter
I read this whole thing and Iâm still confused. Like why are there so many options? Canât we just have one magic pill that fixes everything? Also I think all of these are just Big Pharma trying to sell us stuff. Iâm just gonna drink more coffee and hope it goes away.
Kristy Sanchez
Oh wow another âguideâ telling women what to do with their bodies. Let me guess the IUD is the âbestâ because itâs convenient? What about our autonomy? What about the trauma of insertion? You all act like this is a spa day not a medical procedure.
Michael Friend
The drospirenone pill is a trap. They sell it as âless water retentionâ but guess what? Itâs still a blood clot risk. And they donât tell you that the acne improvement is temporary. Once you stop? Breakouts worse than ever. Donât be fooled.
Jerrod Davis
It is imperative to note that the administration of exogenous progestins may constitute a deviation from physiological hormonal homeostasis. Consequently, the long-term utilization of depot medroxyprogesterone acetate may necessitate supplementary calcium and vitamin D supplementation to mitigate potential osteopenic sequelae.
Dominic Fuchs
The IUD is the only thing that made me feel like I had control again. I used to be a slave to my cycle. Now? I travel. I hike. I forget I even have a uterus. And yes I cried during insertion. But it was worth it.
Asbury (Ash) Taylor
If youâre thinking about switching from Provera to an IUD just talk to your doctor. Theyâll help you time it right. And donât stress about the insertion - most people say itâs less painful than they expected. Youâve got this.
Kenneth Lewis
I tried norethindrone for 3 months and it was like nothing happened. Still bled like a faucet. Then I went to the IUD and boom. No more pads. No more panic. Best decision ever. Also I spelled IUD wrong like 5 times in this comment oops.
Jim Daly
Provera is the devil. I gained 30 lbs. My mood was trash. My hair fell out. I switched to the IUD and now I look like a different person. Also I think the guy who wrote this is a pharma shill but hey the info is kinda useful so whatever.
Tionne Myles-Smith
Youâre not alone. I was scared to try the IUD too. But I did it. And now I feel free. Like I finally got my body back. If youâre reading this and youâre nervous - youâve got a whole community here cheering you on đȘâ€ïž
Leigh Guerra-Paz
I just wanted to say thank you for writing this - itâs so hard to find clear info without being talked down to. Iâve been on Provera for a year and the weight gain was crushing me. Iâm scheduling my IUD appointment next week. Youâre all so brave for sharing your stories - it means more than you know.
Jordyn Holland
Of course the IUD is âbestâ - because itâs the most profitable for doctors and Big Pharma. Meanwhile real women are being gaslit into thinking their bodies are broken. Maybe if we stopped treating menstruation like a disease we wouldnât need all these âsolutionsâ.