Glossary · Treatments

Estrogen-only HRT

Also called: ET, Estrogen therapy.

Definition: Estrogen-only HRT is hormone therapy with estrogen alone, without a progestogen. It is appropriate only for women without a uterus — typically after hysterectomy. Without progestogen protection, estrogen overgrows the endometrium and substantially raises endometrial cancer risk, so estrogen-only HRT is contraindicated in women with an intact uterus.

Detailed definition

Estrogen-only HRT (also called ET, estrogen therapy) is the standard regimen for women who have had a hysterectomy. Because there is no endometrium to protect, no progestogen is required. The WHI estrogen-only arm (using oral conjugated equine estrogens) actually showed a reduction in breast cancer incidence in long-term follow-up, in contrast to the estrogen-plus-progestin arm that drove the 2002 WHI headlines. This finding is one of the strongest pieces of evidence that the WHI breast cancer signal was driven by the synthetic progestin (medroxyprogesterone), not estrogen itself. Estrogen-only HRT is also occasionally used in women with a uterus who have a 52-mg LNG-IUD providing local endometrial protection, although this is technically still combination HRT.

Why it matters in menopause

Many post-hysterectomy women avoid HRT because they associate it with the WHI scare — but the WHI estrogen-only arm actually showed favorable cardiovascular and breast cancer outcomes. For post-hysterectomy women in the timing window, estrogen-only HRT is a particularly clean intervention.

Sources

External references: Wikipedia.

← Back to full glossary