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Progestational medication can significantly reduce the risk of endometrial hyperplasia when used in conjunction with estrogen therapy in perimenopausal women. This is particularly important because unopposed estrogen therapy (estrogen without progestin) can stimulate the endometrial lining, leading to hyperplasia, which increases the risk of developing endometrial cancer. By adding progestin, the effects of estrogen on the endometrium are counteracted, helping to maintain a healthier balance and significantly lowering the likelihood of hyperplastic changes that could progress to cancer.

This protective effect is crucial for women who are undergoing hormone replacement therapy during the perimenopausal phase when their bodies are transitioning and may have a higher risk of such complications. While other options list important conditions, the specific combination of progestin and estrogen is most directly associated with reducing the risk of endometrial hyperplasia.