Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Progesterone is scientifically validated for use in menopause management, particularly as part of hormone replacement therapy (HRT) in women with an intact uterus. The primary reason for prescribing progesterone during menopause is to counteract the proliferative effects of estrogen on the endometrial lining, which, if left unopposed, increases the risk of endometrial hyperplasia and cancer. Clinical guidelines, including those from the North American Menopause Society (NAMS) and the Endocrine Society, recommend combined estrogen-progestogen therapy for menopausal women with a uterus. Multiple randomized controlled trials and meta-analyses confirm that adding progesterone to estrogen reduces endometrial cancer risk compared to estrogen alone.

Progesterone may also have beneficial effects on vasomotor symptoms (e.g., hot flashes) and sleep, although the evidence is less robust compared to its role in endometrial protection. Bioidentical micronized progesterone is considered safer and better tolerated than synthetic progestins, with a lower risk of adverse metabolic and vascular effects.

In summary, the use of progesterone in menopause is strongly supported by scientific evidence, primarily for endometrial protection in women receiving systemic estrogen therapy. Its use for other menopausal symptoms is still under investigation, but its safety and efficacy in HRT protocols are well established.

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