Definition: Endometrial hyperplasia is overgrowth of the endometrium, the lining of the uterus. Estrogen labels call it a possible precursor to endometrial cancer. They say a woman with a uterus who takes estrogen alone has a higher risk, and that adding a progestin lowers the risk of hyperplasia.
| Label | Finding |
|---|---|
| Prometrium (progesterone) | Over 36 months: hyperplasia in 6% on estrogens plus Prometrium vs 64% on estrogens alone and 3% on placebo |
| Premarin | In a 1-year trial: hyperplasia in 5% on 0.625 mg vs 0% on placebo |
| Estradiol tablets | Endometrial cancer risk with estrogen alone about 2 to 12 times non-users, 15 to 24 times with 5 to 10 years or more |
| Bijuva (estradiol and progesterone) | Up to 12 months: hyperplasia in 0.33% and 0.36% on the two doses vs 0% on placebo |
Prometrium is approved specifically to prevent hyperplasia in postmenopausal women with a uterus who take conjugated estrogens.
Not every product uses a progestin. In Duavee, bazedoxifene, a SERM, lowers the hyperplasia risk from the estrogen part. Osphena acts like estrogen in the lining and carries the same endometrial warning. Estrogen labels say unexplained, persistent or recurring bleeding after menopause is checked, including with endometrial sampling when indicated.
Cyclic schedules, such as a progestin on certain days of the month, are easy to get wrong. A log with every estrogen and progestin dose, plus any bleeding days, gives your prescriber the record the labels ask them to check.
Read more on Dose Track: Prometrium side effects · Premarin side effects · Estradiol tablets side effects · Bijuva side effects