Progestogens (sometimes used)

Progestogens (also called progestins) are hormonal agents that mimic the action of natural progesterone and are often used in conjunction with estrogens in hormone replacement therapy—especially in individuals with an intact uterus—to reduce the risk of endometrial hyperplasia and cancer that can arise from unopposed estrogen. They may also be used in other hormonal therapy contexts (e.g., contraception, endometriosis, menstrual regulation). When used in hormone therapy, the choice of progestogen, dose, route (oral, intrauterine, injectable) and duration should be individualized based on patient risk factors, symptom control and monitoring for side-effects (such as mood changes, breast tenderness, fluid retention). Long-term monitoring includes assessing cardiovascular, metabolic, bone and breast health outcomes. Incorporating progestogens allows safer estrogen use in those with a uterus and can help enhance the overall hormonal regimen. It’s important for patients and clinicians to review current guidelines and evidence regarding the type of progestogen and regimen used.