What are the different hormone replacement therapy regimens?
Women with an intact uterus should receive estrogen in conjunction with a progestin to avoid the risk of endometrial hyperplasia (a condition characterized by overgrowth of the lining of the uterus). Women without a uterus (following a hysterectomy) do not need added progesterone. In the cyclical regimen, estrogen is given daily and either by pill or by a skin patch and a progestin is added for days 1-14 of each month. This method causes cyclic bleeding usually at the end of the progestin administration. This method is generally used in women who are recently postmenopausal. In the second method, the continuous method, women are given estrogen and low-dose progestin daily. If heavy bleeding occurs, an endometrial biopsy or vaginal ultrasound may be done to evaluate the bleeding. In most women, within a year the endometrium will stop growing and bleeding will not occur. There are many different types of estrogens and progestins available.
