Can Provera and Althea help regulate irregular periods?

Question

Hello doctor,

I am a 31-year-old female weighing 149.91 pounds. I was diagnosed with polycystic ovary syndrome (PCOS) two years ago. My menstruation has been irregular; sometimes I experience a delay of 3 to 6 months between periods, while at other times, I get my period in consecutive months.

Previously, I was prescribed Provera (Medroxyprogesterone acetate – progestin class) and Althea (Ethinylestradiol + Cyproterone acetate – combined oral contraceptive pill). While taking these medications, my menstruation became regular. My gynecologist advised me to return for a follow-up after six months, but I was unable to do so due to financial constraints. I discontinued the pills, and eventually, I became pregnant. My child is now over a year old, but my menstrual cycle has become irregular again.

I would like to ask if it is safe for me to resume Provera and Althea. If so, could you kindly provide a prescription or guidance on how to properly restart them?

Additionally, I am currently experiencing a recurring yeast infection, which is characterized by itching and a white discharge that resembles cottage cheese.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I suggest considering the following based on your background and current symptoms:

1. Regarding Provera and Althea Pills:

Since you have previously been prescribed Provera (Medroxyprogesterone acetate – progestin class) and Althea (Cyproterone acetate – Antiandrogen class + ethinyl estradiol – estrogen class), and they were effective in regulating your periods, you may be a good candidate to restart them, but only under medical supervision. These medications help manage irregular menstrual cycles, reduce androgen-related symptoms such as acne or hirsutism, and lower the long-term risk of endometrial hyperplasia in women with polycystic ovary syndrome (PCOS).

However, before restarting, the following assessments are necessary:

Blood pressure evaluation.
Liver function tests.
Pregnancy test to rule out current pregnancy.
Updated pelvic ultrasound and a physical examination.

I cannot legally prescribe medications, but I can provide a typical regimen (for informational purposes only) that you can discuss with your gynecologist:

Provera (Medroxyprogesterone acetate – progestin class) 10 mg orally once daily for five to ten days to induce menstruation if amenorrhea persists.

After bleeding begins, Althea (Cyproterone acetate – antiandrogen class + ethinyl estradiol – estrogen class) can typically be started on day one of the menstrual cycle and continued daily for 21 days, followed by a seven-day pill-free interval, before repeating the cycle.

2. Regarding the yeast Infection:

Your symptoms, vaginal itching and thick, white discharge resembling cottage cheese, are consistent with vulvovaginal candidiasis (commonly known as a yeast infection). Women with PCOS may experience recurrent infections due to hormonal imbalances and possible insulin resistance.

First-line treatment (for informational purposes):

Clotrimazole – antifungal class, 500 mg vaginal tablet, single dose inserted at night.
Miconazole – antifungal class, 1,200 mg ovule, single dose inserted vaginally at bedtime.
Optional (if not pregnant or breastfeeding): Fluconazole – antifungal class, 150 mg oral tablet, single dose

Please consider these hygiene tips:

Avoid using scented soaps or cleansers inside the vaginal area.
Wear breathable, cotton underwear.
Maintain optimal blood sugar levels if insulin resistance is a factor.

Next steps:

Schedule a visit with a gynecologist or general physician for updated blood tests and a pelvic exam.
Discuss restarting Althea or switching to a newer-generation combined oral contraceptive pill, if better tolerated.
Seek immediate treatment for the yeast infection.

Consider lifestyle changes such as:

A balanced, anti-inflammatory diet.
Regular physical activity.

Nutritional supplements such as Myo-Inositol or D-chiro-inositol (a nutraceutical or insulin sensitizer / vitamin-like compound) are used in PCOS management.

I hope this helps.

Thank you.