Postmenopausal women with an intact uterus should not be prescribed:

A. Estrogen/progesterone combination: Combination therapy is recommended for postmenopausal women with an intact uterus to reduce menopausal symptoms while preventing endometrial hyperplasia. Progesterone counteracts the proliferative effects of estrogen on the endometrium, lowering the risk of endometrial cancer associated with unopposed estrogen. B. IM medroxyprogesterone (Depo Provera): Medroxyprogesterone can be used in postmenopausal women for endometrial protection in combination with estrogen therapy. It helps prevent endometrial hyperplasia and provides additional contraceptive or hormonal support if indicated, making it appropriate for use when combined with estrogen. C. Estrogen alone: Administering estrogen alone in postmenopausal women with an intact uterus increases the risk of endometrial hyperplasia and endometrial cancer. Without the protective effect of a progestin, unopposed estrogen stimulates continuous endometrial proliferation, which can lead to malignancy over time. D. Androgens: Androgens may be prescribed in select postmenopausal women for management of hypoactive sexual desire disorder or for severe fatigue and muscle mass loss. They do not stimulate the endometrium and can be used cautiously when indicated, either alone or in combination with estrogen/progesterone therapy.