What is the recommended course for using estrogen therapy in a patient with a uterus?

Using estrogen therapy in a patient with a uterus typically requires a combination with a progestin. This is essential because administering estrogen alone can increase the risk of endometrial hyperplasia, which may lead to endometrial cancer. The addition of a progestin helps to counteract the proliferative effects of estrogen on the endometrial lining, thereby providing a protective effect.

In women with an intact uterus, the combination therapy not only helps in alleviating menopausal symptoms such as hot flashes and vaginal dryness but also ensures that the endometrial lining remains stable. This is crucial for reducing the risk of unwanted side effects associated with unopposed estrogen therapy. Thus, the recommended approach is to use estrogen in combination with a progestin to ensure both effectiveness and safety in managing menopausal symptoms or hormone replacement therapy.