Why is progestogen added to estrogen therapy in women who have an intact uterus?

Why is progestogen added to estrogen therapy in women who have an intact uterus?

• A. To prevent endometrial hyperplasia/cancer.
• B. To enhance mood.
• C. To reduce blood pressure.
• D. To improve skin tone.

Answer: (A)

Estrogen stimulates the lining of the uterus to thicken. In women who still have a uterus, using estrogen alone can cause excessive endometrial growth (endometrial hyperplasia), which raises the risk of progression to cancer. Adding progestogen counteracts this proliferative effect by driving the endometrium toward secretory changes and predictable shedding, effectively protecting the endometrium. That’s why combined estrogen–progestogen therapy is used for women with an intact uterus, while estrogen alone is appropriate for those who’ve had a hysterectomy. The other potential effects listed aren’t the reason progestogen is added.

Estrogen stimulates the lining of the uterus to thicken. In women who still have a uterus, using estrogen alone can cause excessive endometrial growth (endometrial hyperplasia), which raises the risk of progression to cancer. Adding progestogen counteracts this proliferative effect by driving the endometrium toward secretory changes and predictable shedding, effectively protecting the endometrium. That’s why combined estrogen–progestogen therapy is used for women with an intact uterus, while estrogen alone is appropriate for those who’ve had a hysterectomy. The other potential effects listed aren’t the reason progestogen is added.