Efficacy and safety of dydrogesterone monotherapy versus estradiol–dydrogesterone combination therapy in perimenopausal women: a real-world cohort study

Objective To compare the 12-week effectiveness and safety of dydrogesterone monotherapy versus estradiol–dydrogesterone (E2/DYD) combination therapy in women with perimenopausal symptoms in a real-world clinical setting. Methods This retrospective cohort study included 150 women treated at a tertiary gynecological outpatient clinic between July 2022 and January 2025 (dydrogesterone: n=60; E2/DYD: n=90). The primary endpoint was change in the Kupperman Menopause Index (KMI) from baseline to week