IF YOUR HRT HAS TWO HORMONES
Why is a progestogen in my HRT too?
If you still have your womb, the NHS says taking both hormones helps protect against womb cancer.
THE MAIN REASON
With a uterus, estrogen comes with a partner
For HRT tablets, patches, gel or spray, the NHS says a uterus means both hormones, not estrogen alone. The NHS says low-dose vaginal estrogen can be used without a progestogen, even with a womb.
IF YOU'VE HAD A HYSTERECTOMY
Not everyone needs the second hormone
- The NHS recommends estrogen-only HRT once the uterus has been removed
- If you have not had a hysterectomy, the NHS says estrogen gel must be paired with a progestogen
HOW THE SECOND HORMONE ARRIVES
More than one way to get it
- One option is progesterone, a capsule you take by mouth (MedlinePlus)
- The NHS says a progestogen can also come from tablets, or from a hormonal coil (an intrauterine system, IUS) that releases levonorgestrel
- The NHS says some HRT products already contain both hormones in one
WHY YOUR SCHEDULE LOOKS LIKE THAT
Cyclical or every day
- The NHS says cyclical (sequential) HRT is usually recommended if you still have periods
- The NHS says continuous HRT, with both hormones daily, is usually recommended once you haven't had a period for a year
- On a cyclical plan, the NHS says a period at the end of each cycle is expected
Bring this to your appointment
Questions for your doctor
- Do I need a progestogen with my estrogen, given my history?
- Is a cyclical or continuous routine right for my stage?
- What should I expect for bleeding on this plan?
As slides
Sources
- NHS: www.nhs.uk/medicines/hormone-replacement-therapy-hrt/types-of-hormone-
- MedlinePlus: medlineplus.gov/druginfo/meds/a604017.html
General information, not medical advice.





