Progestogens are a broad category of molecules that act at the progesterone receptor in the body. Progesterone is the natural form that your body makes. It is secreted primarily by the corpus luteum, a temporary endocrine gland that the female body produces after ovulation during the second half of the menstrual cycle.

Generally speaking, those in surgical menopause need to take estrogen therapy in order to prevent bothersome menopausal symptoms as well as long-term health risks due to low estrogen.

However, when a person in surgical menopause keeps their uterus (no hysterectomy), a progestogen medication must be added to the estrogen therapy. (This is often called 'add-back').

This addition is because estrogen alone stimulates the thickening of the uterine lining, and this thickening can lead to cancer if it is not counteracted by a progestogen.

For this reason, those who are sensitive to progestogen based treatments will usually have their uterus removed (hysterectomy), along with cervix, as part of their procedure when having their ovaries removed - removing the need to add back progestogens into their system.

Additional reading:
​How Do I Know If I Am Progesterone Intolerant?
​What is the correct surgery for PMDD?

Visit www.iapmd.org/surgery for lots of evidence-based information and resources for those considering, going through or recovering from surgery for PMDD/PME.

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