When can progesterone be added in the treatment of estradiol for women with an intact uterus?

When treating women with an intact uterus using estradiol, adding progesterone is a crucial consideration due to the risk of endometrial hyperplasia, which can occur with unopposed estrogen therapy. The addition of progesterone plays a protective role for the endometrium.

The correct choice to add progesterone for women with an intact uterus is for 12 days of the month. This brief course of progesterone helps to induce a withdrawal bleed, mimicking a natural menstrual cycle and reducing the risk of endometrial proliferation caused by estrogen therapy. This is especially important in managing the menstrual cycle and minimizing potential adverse effects associated with prolonged estrogen exposure.

Other options do not align with established practice. Citing continuous use of progesterone may not be necessary in every treatment scenario and can lead to side effects without the need for constant protection. The timing or conditions when to add progesterone does not typically depend solely on presenting symptoms such as hot flashes or estrogen levels.