What is the Origin of Continuous Combined HRT?

The concept of Hormone Replacement Therapy evolved from the mid-20th century to address the physiological changes of menopause, initially focusing on estrogen for symptom relief. The subsequent need to mitigate the risk of endometrial hyperplasia and cancer caused by unopposed estrogen led to the inclusion of progestogens in the regimen. The continuous combined regimen was specifically developed to eliminate the predictable, cyclical bleeding, offering a preferred bleed-free option for women who are years past their final menstrual period.

What is the Mechanism of Continuous Combined HRT?

Estrogen is administered continuously to manage menopausal symptoms by binding to estrogen receptors in target tissues, including the hypothalamus for thermoregulation and bone for maintenance. The simultaneous, continuous administration of the progestogen counteracts the proliferative effect of estrogen on the endometrium, maintaining it in an atrophic, non-proliferative state. This consistent, balanced hormonal delivery provides systemic benefits while minimizing the specific risk of endometrial pathology associated with estrogen-only therapy.

Continuous Combined HRT

Meaning

Continuous Combined Hormone Replacement Therapy (HRT) is a specific therapeutic regimen where both estrogen and a progestogen are administered daily without a break in either hormone. This therapeutic approach is primarily utilized for postmenopausal women to alleviate vasomotor symptoms and prevent bone mineral density loss. Unlike sequential regimens, this continuous co-administration aims to prevent the monthly withdrawal bleeding often associated with cyclical HRT. It provides a steady-state hormonal environment to optimize symptom management and improve overall quality of life.