Progesterone in menopause hormone therapy: basics
Direct answer
When systemic oestrogen is prescribed to someone who still has a uterus, guidelines typically require **endometrial protection** — often with a **progestogen** in a regimen tailored to bleeding pattern, risk factors, and tolerance. Formulations, doses, routes, and whether a **levonorgestrel intrauterine system** can substitute for part of oral progestogen therapy are individual decisions; articles can explain categories, not choose your prescription.
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Why this matters clinically
Unopposed oestrogen in a uterus-bearing person increases endometrial hyperplasia risk over time — progestogens are not an optional ‘add-on’ in many regimens; they are part of safety framing.
What patients can track usefully
Bleeding pattern after starting or changing therapy, mood or sleep changes, bloating, and headache timing — useful data for review visits, not for internet dosing.
Boundaries
Do not use this page to start, stop, or switch hormones without medical review — interactions and contraindications are individual.
Preparing for care
If symptoms are affecting sleep, work, or peace of mind, use this lane to move from "noticing" to a focused visit — without skipping safety signals.
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Frequently asked questions
More in this topic
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- Joint pain and body aches in perimenopauseMusculoskeletal complaints are common around the menopause transition: what patterns are typical, what warrants investigation, and how to describe pain clearly.
- Non-hormonal treatments for menopause symptomsAn overview of non-hormonal options clinicians may discuss for hot flashes, sleep, and mood — framed for shared decision-making, not DIY treatment plans.
- Menopause, heart health, and cardiovascular riskHow cardiovascular risk evolves around midlife, what hormone therapy does and does not imply for heart health, and why personalised risk assessment matters.
- Osteoporosis basics after menopauseWhy bone density often declines after menopause, what DEXA and FRAX are for, how falls and fractures link to independence, and how this sits beside heart-health conversations.
- Menopause clinical trials and evidence (basics)How randomised trials, observational studies, and guidelines differ, why hormone therapy evidence looks ‘confusing’ online, and how to read claims without falling for certainty marketing.
Related reading
- HRT: benefits and risks (basics)A neutral overview of what hormone therapy can do, what risks are discussed in guidelines, and why decisions are individual — not a prescribing guide.
- Menopause, heart health, and cardiovascular riskHow cardiovascular risk evolves around midlife, what hormone therapy does and does not imply for heart health, and why personalised risk assessment matters.
- Vaginal dryness and genitourinary symptomsGenitourinary syndrome of menopause in plain language: dryness, irritation, urinary symptoms, and why local therapies differ from systemic hormone therapy.
MenoTime Editorial
Medically reviewed by Clinical reviewer (add name and credentials) · Last reviewed
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Educational information only
This page is not medical advice, diagnosis, or treatment. It is intended to help you prepare for conversations with a qualified healthcare professional. Always consult a clinician about your personal symptoms, medications, and care plan.