OBJECTIVE: This study was undertaken to identify the determinants of patient satisfaction with a cyclic regimen of medroxyprogesterone acetate (MPA) for abnormal uterine bleeding. STUDY DESIGN: A prospective cohort study of 413 premenopausal women were treated for 3 to 5 months with oral MPA 10 to 20 mg per day for 10 to 14 days per month. We assessed satisfaction with and willingness to continue MPA. Baseline characteristics hypothesized to predict treatment satisfaction were entered into logistic regression analysis. RESULTS: Sixty-five percent of subjects (271) completed at least 3 months of MPA, 79% (215) filled out a satisfaction survey, and 57% (123) expressed satisfaction with MPA. Satisfaction was predicted by age 35 years or older (odds ratio [OR] 2.67, Cl 1.07-6.7), desire for uterine conservation (OR 1.36, Cl 1.11-1.66), perceived importance of stopping bleeding (OR 0.69, Cl 0.54-0.87), and tubal sterilization (OR 0.52, Cl 0.28-0.96). Neither bleeding history nor parity predicted MPA satisfaction. CONCLUSION: These findings underscore the importance of considering patient age, fertility status, attitudes about uterine conservation, and desire for definitive resolution of bleeding when deciding whether to use MPA versus other treatments for abnormal uterine bleeding.