Change to the Progestogen dose for Endometrial Protection in HRT
In April 2024, The British Menopause Society released a new joint guideline which has made suggested changes to the dose of progesterone for women on oestrogen for HRT.
This comprehensive new Guideline was produced by the British Menopause Society (BMS) in partnership with the British Society of Gynaecological Endoscopy, British Gynaecological Cancer Society, Faculty of Sexual & Reproductive Healthcare, Getting It Right First Time (GIRFT) and the Royal College of Obstetricians & Gynaecologists, in response to the significant increase in women presenting with unscheduled bleeding on HRT.
The progestogen dose change only applies to women on the high dose oestrogen regimens.
| Route of administration | Dose per day |
| Oestrogel | 4 pumps |
| Patch | 100mcg |
| Oral Oestradiol | 4mg* |
If you are taking any of the preparations above, at the high dose regimens, the progestogen dose needs to be balanced to reduce the risk of endometrial cancer and unscheduled bleeding.
We are looking to change women to the higher doses outlined below and so you may see a change in your prescription. If this change has not been made, please contact your usual GP or our pharmacy team within Beacon Medical Group to discuss the change.
| Microionised Progestogen (e.g. Utrogestan) | Medroxyprogesterone (e.g. Provera) | Norethisterone | Mirena | |||
| Every day | 2 weeks on 2 weeks off | Every day | 2 weeks on 2 weeks off | Every day | 2 weeks on 2 weeks off | Continuous |
| 200mg | 300mg | 10mg | 20mg | 5mg | 5mg | 5 years use |
Dr Louise Horrocks
Clinical Lead for Women’s Health at Beacon Medical Group
* Off license use – not recommended by BMS – individual discussion with prescribing clinician needed. Please arrange review if you would like to talk further.