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Menopause

Endometrial hyperplasia

09/16/2008

Question:

I am 52 yo and in perimenopause. I have a history of low progesterone and heavy periods. Over the years I have taken Provera 10mg bid days 12 - 27 of my cycle. For the last 3 years I am on this treatment for 3 months then off for 9 months. Then repeated. Recently, I was changed to Provera 10mg in the a.m. and Prometrium 200mg at bedtime.

Is Prometrium just as effective as the Provera? Regarding endometrial hyperplasia - how long does it take for the endometrium to build up to dangerous levels as I`m off treatment for nine months before resuming treatment for 3? My doctor says this treatment accomplishes a "medical D&C".

Answer:

There are many different ways to use progestestogens to prevent hyperplasia.  Risk of hyperplasia may depend on the amount of body fat or body mass index along with other factors, so it is not possible to give a simple answer as to how long it will take for hyperplasia to develop in a certain individual.  There are a number of different progestogens including Provera and Prometrium.  All can be effective in preventing hyperplasia.  As long as the treatment is keeping your bleeding pattern in the "normal" zone (with regard to frequency and heaviness), it is probably working.  Any unusual bleeding can be evaluated with an endometrial biopsy.

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Response by:

Margery   Gass, MD Margery Gass, MD
Formely, Professor, Clinical Obstetrics & Gynecology
College of Medicine
University of Cincinnati