The discussion of oral contraceptives (OCs) in perimenopausal women (Item 110-20) included the recommendation that “women older than 50 might stop the pill altogether or change to an estrogen-only regimen if needed for symptoms.” Switching to an estrogen-only regimen for menopausal symptoms may cause women with a uterus to develop endometrial hyperplasia and increase the risk for endometrial cancer. These women should also be given progesterone (either cycled or daily) with their estrogen.
—Serena Luce, PA-C, Columbia, Mo.

Your feedback is well-taken. Women who have an intact uterus should certainly receive a progestin as well, since endometrial hyperplasia and cancer can occur after as little as six months of unopposed estrogen therapy. Thanks for pointing this out.
—Reuben W. Zimmerman, PA-C (113-23)

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