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Dr. Renee M. Nelson, MD, MSCP

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🩷Perimenopause + Menopause
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The British Menopause Society publishes a clinician tool on progestogens and protecting the uterine lining, and the 2026 version has been going around Facebook. It’s a good document. It’s also written for UK pharmacies, so an American woman reading it hits names she has never seen on a bottle.

The principles cross the Atlantic intact. With a uterus, estrogen needs a progestogen. In a sequential regimen that’s 12 to 14 days a month, and studies suggest fewer than 10 days carries more risk of hyperplasia and endometrial cancer. In a continuous regimen it’s every day.

The products are what change.
Utrogestan is the UK’s micronized progesterone; here it’s Prometrium or its generics, which contain peanut oil.
Norethisterone is the molecule Americans call norethindrone.
The UK combined patches have US counterparts in CombiPatch and Climara Pro, both with a synthetic progestin.
Dydrogesterone isn’t sold here at all.

The Mirena IUD, which the UK licenses for this job, has no FDA approval for it. Its US label covers contraception and heavy periods. Using it as the progestogen alongside estrogen is common, and off-label.

Save this for the next time a British guideline lands in your feed.

I’m a doctor, but not your doctor. Everything here is for education, not medical advice. Stay curious, stay evidence-based, and always talk to your clinician before making changes.
 #ScienceStraightTalkSass #ThisMenoLife

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