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Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 3064
Experience:  30 years of experience and an award-winning educator.
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I am on hrt (estrace - 1.5mg/day and progesterone -

Customer Question

i am on hrt (estrace - 1.5mg/day and progesterone - compounded 37.5/day). i now have hyperplasia with mild atpyia. the ob gyn wants me to stop taking estrace and take progesterone for three months (200 mg) or get a hysterectomy. are there any other alternatives to eliminate the problem. do i need to stop the estrogen. my hair has been falling out. i had blood work done that showed high levels of testosterone.
Submitted: 9 months ago.
Category: OB GYN
Expert:  Dr. C. replied 9 months ago.

Hi, It's Dr. C. Board certified Ob-gyne with 30+ years of experience. I do have extensive experience in menopausal management.

I'm very sorry to hear about this worry. With the doses of estrogen versus progesterone, it doesn't surprise me that the is a hyperplasia developed. Because the doses don't seem well balanced, hopefully the condition can be reversed. An alternative would be to slightly decrease the estrogen dose to maintain symptoms relief while boosting the progesterone level as you doctor has suggested. I can understand why he or she is most comfortable with stopping the estrogen altogether. Another alternative is to place a progesterone intrauterine device (Mirena IUD) to delivery the progesterone directly to the hyperplasia for more effective treatment. Normally in this situation we'd monitor every 3 months to see the impact of the treatment. The risk if as you already know, that a uterine cancer could develop. Stopping the estrogen right now decreases the risk that would happen but if you felt strongly about continuing the estrogen, a Mirena IUD with repeat evaluation of the lining in 3 months would be an ok alternative.

Any questions?

Expert:  Dr. C. replied 9 months ago.

Please let me know if you have any questions. I want to be sure you have the most helpful information for your situation.

Expert:  Dr. C. replied 9 months ago.

If no questions, please leave a rating for my service. I aim for excellent and appreciate your feedback. Thanks.