Is medroxyprogesterone safe in women with long QT syndrome?

  title={Is medroxyprogesterone safe in women with long QT syndrome?},
  author={Jonathan R. Skinner and Jamie I. Vandenberg},
  journal={Heart rhythm},
  volume={9 7},
G Twenty-two percent of women in the United States use depot medroxyprogesterone acetate (MPA) at some stage in their life for contraception. It is highly effective, can be elf-administered, and has high adherence rates. The World ealth Organization lists it as a first-line option for young omen, particularly those wishing to avoid the adverse ffects of estrogens, such as breast-feeding mothers, smokrs, those who are overweight, and those with atrial fibrilation, pulmonary hypertension… 


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Potential depot medroxyprogesterone acetate-triggered torsades de pointes in a case of congenital type 2 long QT syndrome.
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Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs.
It is strongly suggested that women are more prone than men to develop torsades de pointes during administration of cardiovascular drugs that prolong cardiac repolarization.
Drug-induced QT prolongation in women during the menstrual cycle.
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Estradiol promotes sudden cardiac death in transgenic long QT type 2 rabbits while progesterone is protective.
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Gender disparity in cardiac electrophysiology: implications for cardiac safety pharmacology.
The testosterone-mediated increase in repolarization reserve in men is a likely cause for their lower susceptibility to drug-induced TdP, and this is a possible confounding factor in the evaluation and comparison of drugs that has to be further tested.
Progesterone Regulates Cardiac Repolarization Through a Nongenomic Pathway: An In Vitro Patch-Clamp and Computational Modeling Study
The data show that progesterone modulates cardiac repolarization by nitric oxide produced via a nongenomic pathway, which provides a framework to understand complex fluctuations of QT interval and torsade de pointes risks in various hormonal states in women.
Progesterone Impairs Human Ether-a-go-go-related Gene (HERG) Trafficking by Disruption of Intracellular Cholesterol Homeostasis*
Investigation of the effect of progesterone on the expression, trafficking, and function of HERG channels and the underlying mechanism may reveal a novel molecular mechanism to explain the QT prolongation and high risk of developing arrhythmias during late pregnancy.
Estrogen and Progestin Use and the QT Interval in Postmenopausal Women
To determine whether menopausal hormone therapy alters the QT interval in primarily healthy postmenopausal women, a large number of women thought to be eligible for treatment with menopausal hormones are surveyed.