Uterine buildup and hrt

I am menopausal and was on hrt for five years because of hot flashes. Only symptom I was having at the time I was put on hrt. About 9 months ago I found out I had endometrium hyperplasia ( uterine buildup right), so I had a choice to stay on hrt or to go off it and keep having tests to make sure it doesn't come back. I also had to have a d and c. I decided to wean of hrt over a few months. My hot flashes are back with a vegence, but different than they were before.I don't break out in a sweat like I did before,just feel warm and it starts at my neck and my face is not flushed looking, but feels warm and my stomach too. I got my test results for estrogen and progesterone, and my estrogen is very low. I was not able to see my regular doc to get results, so I saw her hubby. He told me to discuss this with her. If I go back on hrt, Imay get cancer he said or the same problem as before. I don't know what to do. I put myself on promensil and its only been 2 weeks. I can't see my own doc til Jan. Do you have any suggestions for people that have this problem like me?

[Machelle Seibel, MD]

A. HRT includes both estrogen and progesterone for women with a uterus to prevent the buildup of the uterine lining that you describe.  If you take estrogen for a month, ideally you should take progesterone with it the last two weeks.  This will cause a period or some staining but it is the staining that sheds the lining of the uterus and prevents it from building up.

Often, if the lining has endometrial hyperplasia, it can be treated with higher dosages of progesterone for about 3 to 6 months. It is reasonable to do a D&C to be sure there is no cancer but cancer usually takes longer than 5 years to develop. Most of the time the endometrial hyperplasia will go away with the progesterone as long as it is taken at least 10 days of each month.

You may want to wean off estrogen if you are worried, but adjusting the dose of estrogen and progesterone often solves the problem you are describing.
Machelle M. Seibel, MD

[hashi]

I am not on any hrt at all. So what you are saying is it should be okay to go back onto hrt and not have to worry about my previous problem coming back? I'm confused. Isn't that what caused the problemin the first place? How does a higher dose of hrt help stop uterine buildup?