High-dose depot-medroxyprogesterone acetate (DMPA) - effects on lipid and lipoprotein metabolism

Twenty-one women were given depot-medroxyprogesterone acetate (DMPA) 1000 mg/wk for 6 mth as part of the treatment for endometrial carcinoma in either clinical stage I or II. Total and free cholesterol, triglycerides and phospholipids were analysed in serum and in the ultracentrifugally separated lipoprotein fractions VLDL, LDL and HDL (very low, low and high density lipoproteins). Previous studies have shown little effect on lipoprotein metabolism after lower doses of MPA, unlike progestins of the 19-nor-testosterone series, after which an 'androgenic' lipoprotein pattern is seen, i.e., a decrease in HDL-cholesterol and in triglycerides in serum and VLDL. After this massive DMPA dose, only a slight decrease in HDL-cholesterol was seen, as well as a rise in triglycerides in serum and VLDL. We interpret the latter finding as secondary to an influence on carbohydrate metabolism.