Progesterone Dosage for HRT with Estradiol Patch

Introduction to Progesterone Regimens

The recommended progesterone dosage for women using an estradiol patch 0.0375 mg for hormone replacement therapy is 200 mg of oral or vaginal micronized progesterone daily for 12-14 days every 28 days in a sequential regimen, as suggested by the guidelines from medical societies 1, 2

Micronized progesterone is the first choice for endometrial protection due to its physiological profile and lower risk of cardiovascular disease and venous thromboembolism, according to the American College of Obstetricians and Gynecologists 2, 3
For sequential regimens with transdermal estradiol, 200 mg of oral or vaginal micronized progesterone daily for 12-14 days every 28 days is recommended, as per the guidelines from the Endocrine Society 1, 4
Alternative options if micronized progesterone is contraindicated include 10 mg medroxyprogesterone acetate or 10 mg dydrogesterone daily for 12-14 days per month, as suggested by the American College of Obstetricians and Gynecologists 2, 4

A sequential regimen with withdrawal bleeding involves transdermal estradiol administered continuously and progesterone administered for 12-14 days every 28 days, according to the guidelines from the North American Menopause Society 1, 4
A continuous regimen without withdrawal bleeding involves both estradiol and progesterone administered continuously, as recommended by the Endocrine Society 2, 5

For women with premature ovarian insufficiency, hormone replacement therapy should be continued until the average age of natural menopause, as suggested by the American College of Obstetricians and Gynecologists 3
For women with a BRCA gene mutation but no personal history of breast cancer, hormone replacement therapy can be used after prophylactic bilateral salpingo-oophorectomy, according to the guidelines from the Society of Gynecologic Oncology 7

Regular follow-up is recommended to assess symptom control, side effects, and endometrial safety, as per the guidelines from the American College of Obstetricians and Gynecologists 3