From the Guidelines
Progesterone should be prescribed alongside the climate patch for individuals with an intact uterus to prevent endometrial hyperplasia and cancer. The standard regimen includes micronized progesterone 100-200 mg daily or medroxyprogesterone acetate 2.5-5 mg daily for at least 12-14 days per month in cyclic regimens, or continuously in continuous regimens, as recommended by the European Society for Human Reproduction and Embryology (ESHRE) 1. When choosing a progestin, micronized progesterone is preferred due to its favorable profile in minimizing hormonal-related cardiovascular risks and having a neutral or beneficial effect on blood pressure 1. Some key points to consider when prescribing progesterone with the climate patch include:
- The dose of progestogen is based on the concurrent dose of estrogen administered 1
- Patient preference for route and method of administration of each component of HRT must be considered when prescribing, as should contraceptive needs 1
- Monitor for side effects like breast tenderness, mood changes, or bleeding irregularities, which typically improve within 3 months
- Regular follow-up appointments are important to assess effectiveness and adjust dosing as needed. If you don't have a uterus (due to hysterectomy), progesterone is not necessary. It's also important to note that the use of dydrogesterone, a synthetic progesterone with enhanced oral bioavailability, is listed among the suggested progestins by the ESHRE consensus guidelines, but no studies have analyzed its endometrial effects in adult women with POI 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Progesterone and Climate Patch
- The provided studies do not directly address the use of progesterone with a climate patch.
- However, the studies discuss the use of medroxyprogesterone acetate (MPA) in the treatment of endometrial cancer and its efficacy as a progestogen in hormone therapy 2, 3, 4, 5, 6.
- One study suggests that MPA can be effective for treating early-stage endometrial cancer, even when used in combination with a levonorgestrel-intrauterine system (LNG-IUS) 5.
- Another study found that MPA treatment and retreatment can be effective for atypical endometrial hyperplasia and endometrial cancer, with high complete response rates 4.
- The safety and tolerance of progestogens, including MPA, in hormone therapy have been reviewed, with some studies suggesting that micronized progesterone and dydrogesterone may be safer options 3.
- A study on the efficacy and prognosis of adjuvant treatment of endometrial cancer with MPA found that age, pathological type, molecular typing, and myometrial infiltration were factors influencing the prognosis of patients with early-stage high-risk endometrial cancer 6.
Key Findings
- MPA can be effective in treating endometrial cancer, particularly in combination with other treatments 4, 5.
- Progestogens, including MPA, have been used in hormone therapy, but their safety and tolerance have been debated 3.
- The use of MPA in adjuvant treatment of endometrial cancer may have potential long-term prognostic benefits, but more research is needed to confirm this 6.