American Board of Internal Medicine (ABIM) Certification Practice Exam

In the context of menopause, what is the role of estrogen therapy for women without a uterus?

1. Considered risky

2. Should always include progestin

3. Can be utilized without progestin

4. Not recommended

The correct answer is: Can be utilized without progestin

Estrogen therapy can be utilized without progestin for women who have undergone a hysterectomy and no longer have a uterus. The primary reason for this is that progestins are administered in combination with estrogen to protect the endometrial lining from hyperplasia, which could occur if estrogen is taken alone in women who still have a uterus. However, since women without a uterus do not face the risk of endometrial hyperplasia, they can safely receive estrogen therapy alone to help manage menopausal symptoms such as hot flashes, night sweats, and vaginal dryness. This tailored approach to hormone therapy allows for symptom relief while avoiding unnecessary medications that aren't needed due to the absence of uterine tissue.