17beta-estradiol + progesterone

17beta-estradiol + progesterone (Massachusetts General Hospital regimen) is an investigational hormone replacement therapy (HRT) specifically designed to treat exercise-related amenorrhea and improve bone health in adolescent and young adult endurance athletes. The regimen consists of a 100-μg transdermal 17β-estradiol patch applied continuously, paired with 200 mg of cyclic oral micronized progesterone (Prometrium) administered for 12 days each month. Unlike standard oral contraceptives that use synthetic ethinyl estradiol, this approach utilizes physiologic 17β-estradiol delivered transdermally to bypass first-pass hepatic metabolism, thereby avoiding the suppression of insulin-like growth factor 1 (IGF-1) and other bone formation markers. The therapy acts as an agonist at estrogen and progesterone receptors to restore hormonal balance and improve bone mineral density and microarchitecture in individuals with functional hypothalamic amenorrhea due to low energy availability.

Brand names

Prometrium

Other names

transdermal 17beta-estradiol and cyclic oral micronized progesteronetransdermal17beta-estradiol and cyclic oral micronized progesteronetransdermal-17beta-estradiol and cyclic oral micronized progesteroneMGH HRT regimen17beta-estradiol + progesterone-Massachusetts General Hospital-exercise-related amenorrhea