A recent survey of 154 women showed that 67% of women did not know they may be at an increased risk for uterine cancer if they do not use a progestogen while taking estrogen as part of their hormone regimen.[1]

• Before menopause, hormone levels change throughout the month.
  
  
• Three major sex hormones exist in your body: estrogen, progesterone, and testosterone.
  
  
• Before menopause, some women who have previously had a period may experience the absence of regular periods for 6 months or more. This condition is called secondary amenorrhea.[2]
  
  
• Estrogen thickens and builds the lining of your uterus (called the endometrium) each month to prepare your body for pregnancy.
  
  
• When pregnancy doesn’t occur, both estrogen and progesterone levels suddenly drop at the end of each cycle, and the uterus sheds its lining.[3]
  
  
• A major change in your hormone levels happens during menopause, when the menstrual cycle gradually shuts down. For example, after menopause, your body makes approximately one half the amount of progesterone it
  used to.[3]
  
  
• In postmenopausal women with a uterus who are taking estrogen alone, the lining of the uterus stays thick and full of blood. If that lining stays thickened month after month, it can be unhealthy. This can increase the chances of the uterine lining becoming too thick, which is a condition called hyperplasia.[3] This is why it is important to add a progestogen to estrogen therapy.
  
  
• Click here to complete the Menopause Assessment Tool

Estrogen is often prescribed for the treatment of menopausal symptoms such as hot flashes, night sweats, and vaginal dryness.[4] If you have a uterus, your healthcare provider may prescribe a progestogen with your estrogen or estrogen-androgen therapy.

Why? Well, progestogens:

• Help shed your uterine lining and prevent the development of hyperplasia.[5]
  
  
• Help prevent abnormal cells from growing in the estrogen-thickened lining of the uterus, or endometrial hyperplasia.[5]
  
  
• May be prescribed for part or all of your monthly cycle (the dosing schedule will determine whether you have your period).[5,6]
  
  
• May lead to side effects such as spotting, menstrual cramps, bloating, drowsiness, dizziness, breast tenderness, headache, and mood swings.[5,6]

• Recommended dosing for hormone therapy with PROMETRIUM® is
  200 milligrams at bedtime for 12 days in a row per 28-day cycle.[5]
  
  
• When used to treat secondary amenorrhea, the recommended dosing of PROMETRIUM® is 400 milligrams at bedtime for 10 days.[5]
  

Which progestogen therapy is right for you?

• Progestins are synthetic (man-made) progestogens made from plants. Although they are different from natural progesterone, progestins are made to react in a similar way in your body.[6] The clinical significance of this difference is not known.
  
  
• In the last decade, researchers have found a way to produce a natural progesterone (like your body makes) in a form that can be taken orally.

• Using a process known as micronization, researchers have developed a progesterone that’s easy for the body to absorb.[6] The way your body processes micronized progesterones versus progestins is also different, and that is why dosing varies among progestogens.[6]

• Women who have had a hysterectomy do not need to take a progestogen.[5]

[6]

References:
1. Understanding the use of progesterone and progesterone-like hormones. MenopauseRx Web site. Available at: http://www.menopauserx.com/library/surveyinfo-Progesterone.htm# background. Accessed February 7, 2007. 2. O’Connor V, Kovacs G, eds. Obstetrics, Gynaecology, and Women’s Health. Cambridge, England: Cambridge University Press; 2003. 3. Beers MH, Berkow R, eds. The Merck Manual. 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999. 4. Bachmann GA, Simon JA, Sarrel PM. Considerations in managing your HRT patients. Contemp OB/GYN. 1997:34-47. 5. PROMETRIUM® [package insert]. Marietta, Ga: Solvay Pharmaceuticals, Inc.; 2004. 6. Role of progestogen in hormone therapy for postmenopausal women: position statement of the North American Menopause Society. Menopause. 2003;10:113-132.