Hormone Therapy for Endometrial Cancer: What to Know

Written by Janie McQueen
Medically Reviewed by Laura J. Martin, MD on March 03, 2025
5 min read

Hormone therapy for endometrial cancer helps control or stop the growth of cancer cells in the lining of your uterus, called the endometrium. This treatment isn’t the same as hormone treatment for menopausal symptoms, which aims to replace and rebalance female hormone levels that drop with age.

Hormones are chemical messengers in your blood that help control body processes such as cell growth, metabolism, and other functions. Drugs that contain or mimic progesterone, one of the two main hormones of the female reproductive system, are the most prescribed hormone therapy for endometrial cancer. It’s used when there’s not enough progesterone in your body to balance out estrogen levels.

Often paired with chemotherapy, this type of hormone therapy is usually prescribed for more advanced endometrial cancer, such as stage III or IV. But it can also be helpful in other cases, such as: 

  • When surgery or radiation treatment isn’t an option
  • If the cancer comes back after treatment
  • If you’re in early stages and wish to get pregnant
  • If the cancer has spread to other parts of your body

“It utterly depends on the situation for which it is being used, such as cancer prevention, initial fertility-sparing treatment, or recurrent tumors,” says Susan C. Modesitt, MD, professor and chair of the Department of Gynecology and Obstetrics at the Emory University School of Medicine. She prefers the term “hormonal treatment of endometrial cancer” to set it apart from hormone replacement therapy, which replenishes supplies of female hormones to ease menopause symptoms.

Drugs used to help control cancer cell growth include progestins, tamoxifen, aromatase inhibitors, and luteinizing hormone-releasing hormone agonists.

 Progestins

The main treatment for hormone therapy for endometrial cancer is progesterone or synthetic versions of the hormone, which are called progestins. They’re used to slow the growth of endometrial cancer cells.

Whether progesterone is the right choice to treat endometrial cancer depends on many things, including your age, the stage of the cancer, and whether your treatment has included surgery to remove your uterus and cervix, which is common.

“In a patient who has a uterus, you have to give progesterone,” says Gerald Feuer, MD, a gynecologic oncologist at Atlanta Gynecologic Oncology.

Modesitt notes, “Progesterone therapy is often given alone for young women with early-stage, low-grade endometrial cancer who are trying to reverse the cancer and enable pregnancy.” 

The two most used progestins are medroxyprogesterone acetate (Provera) – which you take as a pill or an injection – and megestrol acetate (Megace), which comes as a pill or a liquid.

Early-stage endometrial cancers can sometimes be treated with an intrauterine device (IUD) that contains a progestin called levonorgestrel. It might be prescribed with another hormone drug, such as a luteinizing hormone-releasing hormone agonist.

Tamoxifen

Tamoxifen (Nolvadex, Soltamox) is widely used to treat breast cancer. Tamoxifen keeps estrogen from making cancer cells grow. It may help treat advanced-stage or recurrent endometrial cancer.

Some doctors alternate progesterone and tamoxifen to help regulate the side effects (see section below). You take tamoxifen as a pill or liquid.

Luteinizing hormone-releasing hormone agonists

Also called gonadotropin-releasing hormone (GNRH) agonists, luteinizing hormone-releasing hormone (LHRH) agonists are another option for women who still have working ovaries. LHRH agonists release hormones that lower estrogen levels and keep the ovaries from making estrogen.

Goserelin (Zoladex) and leuprolide (Lupron) are drugs that might be used to treat endometrial cancer. You receive the medication as a shot every one to three months.

Aromatase inhibitors

Even if your ovaries have been removed, your fat tissue still makes estrogen. Aromatase inhibitors stop this estrogen production. Most often used in breast cancer treatment, aromatase inhibitors can be helpful as hormone therapy for endometrial cancer, especially if you can’t have surgery. 

Aromatase inhibitors include anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara).

“Hormonal therapy in tumors and cancers is actually aimed at blocking the person's own hormones from their normal growth,” says Modesitt. Hormone therapy slows the growth of endometrial cancer by cutting or reducing the supply of estrogen that feeds it. 

Your treatment specialist will be a gynecologic oncologist, a doctor who treats female cancer, or a medical oncologist, a doctor who specializes in using meds to treat cancer. They’ll decide which medicines might work best, weighing factors such as your age, the stage of the cancer, and whether you’ve had your uterus and cervix removed.

You’ll take prescribed medication by mouth or injection.

Progestins

Side effects include menopausal symptoms such as night sweats and hot flashes. Others are: 

  • Increased appetite that can lead to weight gain
  • Fluid retention
  • Worsening depression
  • Increased blood sugar levels if you have diabetes
  • Blood clots, though not common

Tamoxifen

Side effects of tamoxifen include:

  • Vaginal dryness
  • Hot flashes
  • Higher risk for blood clots in your legs

Luteinizing hormone-releasing hormone agonists (LHRH)

Side effects of LHRH agonists include:

  • Vaginal dryness
  • Hot flashes
  • Aches in joints and muscles
  • With long-term use, bone weakening that can lead to osteoporosis

Aromatase inhibitors

Side effects of aromatase inhibitors include:

  • Hot flashes
  • Pain in muscles and joints
  • With long-term use, bone weakening that can lead to osteoporosis

Hormone therapy for endometrial cancer is usually prescribed if you have later-stage cancer, and sometimes if you have working ovaries and want to get pregnant. The main way they work is to stop estrogen from feeding the cancer or stop your body from making estrogen. Hormone types can be combined, and are often paired with chemotherapy. Hormone therapy is given as a pill, a liquid, or injection.

What is the hormone treatment for endometrial cancer?

Hormone treatment for endometrial cancer uses medicines such as progestins – which mimic the hormone progesterone – to control the level of estrogen in your body or keep your body from making it. It’s usually prescribed for people with stage III or IV endometrial cancer or people who’ve had treatment but have had the cancer return.

Is hormone therapy for endometrial cancer safe? 

Hormonal therapy usually causes few problems.