The impact of micronized progesterone on the endometrium: a systematic review
Open accessAbstract
Postmenopausal women with an intact uterus using estrogen therapy should receive a progestogen for endometrial protection. International guidelines on menopausal hormone therapy (MHT) do not specify on progestogen type, dosage, route of application and duration of safe use. At the same time, the debate on bioidentical hormones including micronized progesterone increases. Based on a systematic literature review on micronized progesterone for endometrial protection, an international expert panel's recommendations on MHT containing micronized progesterone are as follows: (1) oral micronized progesterone provides endometrial protection if applied sequentially for 12-14 days/month at 200 mg/day for up to 5 years; (2) vaginal micronized progesterone may provide endometrial protection if applied sequentially for at least 10 days/month at 4% (45 mg/day) or every other day at 100 mg/day for up to 3-5 years (off-label use); (3) transdermal micronized progesterone does not provide endometrial protection.
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Progesterone allows the proliferative endometrium, stimulated by estrogen, to become secretory, avoiding hyperplasia, a forerunner of endometrial carcinoma.
“This allows the proliferative endometrium, stimulated by estrogen, to become secretory, avoiding hyperplasia, a forerunner of endometrial carcinoma.297”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [297]
The primary indication for adding progesterone is endometrial protection.
“The primary indication for adding progesterone is endometrial protection.”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [297]
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- Authors
- Stute, P., Neulen, J., & Wildt, L.
- Affiliations
- University of Bern (CH)
- RWTH Aachen University (DE)
- Innsbruck Medical University (AT)
- Corresponding author
- Stute, P.
- Venue
- Climacteric
- Publisher
- Informa UK Limited
- Published
- 2016-06-09
- Volume
- 19
- Issue
- 4
- Pages
- 316-328
- ISSN
- 1369-7137 (ISSN-L)
- 1473-0804
- OpenAlex
- W2409789623
- Cited by
- 109
- References
- 52
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 11 · 2023: 9 · 2022: 12 · 2021: 20 · 2020: 9 · 2019: 12 · 2018: 7 · 2017: 8 · 2016: 2
- FWCI
- 1.42
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Climacteric (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion, cc-by-nc-nd)
- RWTH Publications (RWTH Aachen) (submittedVersion, other-oa)
- Funders
- The board meeting was funded by DR. KADE/BESINS Pharma GmbH without influence on the content.
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- micronized progesterone, endometrial protection, hormone replacement therapy, progestogens, postmenopausal women, estrogen therapy, bioidentical hormones, vaginal micronized progesterone, sequential dosing, expert panel recommendations
- MeSH terms
- Administration, Cutaneous, Administration, Intravaginal, Administration, Oral, Endometrium, Female, Humans, Menopause, Progestins, Progesterone, Uterus, Vagina, Estrogen Replacement Therapy, Practice Guidelines as Topic
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