A 48-year-old woman with FSH 68 IU/L and amenorrhea for 14 months presents with vasomotor symptoms. She has an intact uterus and requests HRT. The appropriate regimen is:

• A Combined continuous estrogen and progestogen ✓
• B Estrogen alone (continuous)
• C Estrogen alone (cyclic)
• D Progestogen alone

Explanation

Women with an intact uterus who receive estrogen therapy must have progestogen added to protect the endometrium from unopposed estrogen stimulation, which causes hyperplasia and carcinoma. After 12 months of amenorrhea (confirmed menopause), continuous combined HRT (rather than sequential) is preferred to avoid withdrawal bleeding and provide endometrial protection. Estrogen alone is only appropriate after hysterectomy.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.