Medroxyprogesterone acetate acutely facilitates and sequentially inhibits sexual behavior in female rats

Medroxyprogesterone acetate (MPA), a synthetic progestin commonly used in contraception and hormone replacement therapy, appears to inhibit libido in women, but little is known about the mechanisms through which it may exert this effect. We compared the acute and sequential actions of MPA and natural progesterone (P4) on sexual behavior in female rats to test the hypothesis that MPA inhibits sexual behavior, at least in part, by acting as a potent progesterone receptor (PR) agonist. Ovariectomized females were placed in one of three dose groups (high, mid, or low), and each subject was tested under three different conditions (MPA, P4, and vehicle). The order of progestin treatment was balanced among subjects, and within each dose group equimolar quantities of MPA and P4 were administered. During each trial, females were injected with estradiol benzoate (EB, 4 μg) followed by one of three progestin treatments (MPA, P4, or vehicle) at +44 h, and behavioral testing at +48 h. On the next day, all females were given a standard 500-μg injection of P4 at +68 h and were tested again for sexual behavior at +72 h. On the first day of behavioral testing, both MPA and P4 induced a pronounced rise in receptive and proceptive behavior at the mid and high doses, but at the lowest dose MPA had a much greater effect in comparison to P4. On the second day of behavioral testing, MPA attenuated the expression of proceptive and receptive behavior at both the mid and high doses, whereas P4 only attenuated the expression of lordosis and only did so at the highest dose. These findings illustrate that MPA and P4 have a similar impact on sexual behavior in female rats and suggest that the inhibitory effects of MPA may be attributable, at least in part, to its potent effects at the progesterone receptor.