What treatment option is recommended for women where estrogen is contraindicated?

Progestin-only options are the recommended treatment for women where estrogen is contraindicated, particularly in cases where factors such as history of thromboembolic events, certain types of cancers, or severe migraine with aura may pose risks with estrogen use. Progestins can help manage menstrual cycles and alleviate endometrial-related symptoms without the associated risks of estrogen.

These options work by thinning the endometrial lining and providing hormonal regulation without estrogen, making them safer for individuals who may have contraindications to estrogen therapy. In clinical practice, progestin-only options can be particularly effective in treating conditions like irregular menstruation or as a method of contraception for those with specific medical considerations.

Other treatment options, such as OCPs, which contain both estrogen and progestin, would not be suitable because they include estrogen, which the patient cannot tolerate. GnRH agonists, while effective for certain conditions like endometriosis, are usually reserved for more severe cases and may lead to a hypoestrogenic state, which has its own complications. Endometrial ablation is a surgical procedure rather than a hormonal treatment and is typically used for managing heavy menstrual bleeding, but it also would not address underlying hormonal imbalances. Thus, progestin-only options