Which combination is used in hormone therapy for menopausal symptoms?

• A. Estrogen alone
• B. Progestin alone
• C. Estrogen alone or combined with progestin
• D. Testosterone

Answer: (C)

Managing menopausal symptoms with hormone therapy centers on using estrogen to alleviate hot flashes and vaginal atrophy, with a progestin added if the uterus is still present to protect the endometrium from unopposed estrogen stimulation. Estrogen alone works well for symptom relief, but in people with a uterus it increases the risk of endometrial hyperplasia and cancer unless a progestin is added. If someone has had a hysterectomy, the endometrium is removed, so estrogen can be given by itself without the progestin. Progestin alone doesn’t address the vasomotor or vaginal symptoms and wouldn’t provide endometrial protection when estrogen is used. Testosterone isn’t a standard first-line treatment for menopausal vasomotor symptoms. Therefore, the appropriate regimen is estrogen alone or estrogen combined with progestin, depending on whether the uterus is present.