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Menopause - Management
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Advice for women before starting HRT

What issues should I discuss with a woman before starting HRT?

  • The risks and benefits of hormone replacement therapy (HRT).
  • The expected duration of treatment:
    • Women with premature menopause usually take HRT up to the age of the natural menopause (50 years); at that time, treatment is usually reassessed.
    • Topical (vaginal) oestrogen may be required long term. Regular attempts (at least annually) to stop treatment are usually made. Symptoms may recur once treatment has stopped.
  • Any possible adverse effects such as breast tenderness or enlargement, nausea, headaches, or bleeding.

What advice should I give about the benefits of HRT?

  • Hormone replacement therapy (HRT) is effective for:
    • Treating vasomotor symptoms (e.g. hot flushes and night sweats).
    • Treating urogenital symptoms (e.g. vaginal dryness, dyspareunia as a result of vaginal dryness, recurrent urinary tract infections, and urinary frequency and urgency).
    • Sleep or mood disturbances caused by hot flushes and night sweats.
    • Preventing osteoporosis. HRT is not normally used as a first-line treatment (as the risks outweigh the benefits) except in women with premature ovarian failure.
    • Reducing the risk of colorectal cancer (but HRT is currently not recommended for this use).

In depth

What advice should I give about the possible risks of HRT?

  • There is a small increase in risk for:
    • Breast cancer: oestrogens may slightly increase the risk of having breast cancer diagnosed. Combined (oestrogen and progestogen) HRT increases this risk by about 1.6 times after 5 years of use and 2.3 times after 10 years of use. Risk decreases within a few years of stopping HRT.
    • Endometrial cancer: increased risk only with unopposed oestrogen. There is no increased risk with combined (oestrogen and progestogen) HRT.
    • Ovarian cancer: long-term use of oestrogen-only HRT and combined HRT may slightly increase the risk. Risk decreases after stopping HRT.
    • Venous thromboembolism (deep vein thrombosis or pulmonary embolism): the absolute risk is small and may be lower with transdermal than oral oestrogen.
    • Coronary heart disease: the increased risk is for women who have started combined HRT more than 10 years after the menopause.
    • Stroke and dementia: found mainly in women over the age of 65 years.

In depth

Management

How can I manage women with a premature menopause?

  • Offer lifestyle advice.
  • Refer women who are younger than 40 years of age to a gynaecologist.
  • Offer systemic hormone replacement therapy (HRT) or the combined oral contraceptive pill (COC):
    • HRT: the HRT regimens used will depend on whether or not the woman has undergone a hysterectomy, still has some ovarian activity and still has periods.
      • For women who are still having periods offer oral or transdermal, combined cyclical HRT (a 3-monthly regimen may be preferred).
      • For women who have had a hysterectomy offer oral or transdermal oestrogen replacement therapy.
    • COC: whether or not the woman can be prescribed the COC will depend upon the woman's age and associated risk factors (e.g. smoking).
  • Decreased libido: testosterone implants and patches may be considered (especially in oophorectomized women); however, seek specialist advice before prescribing.
  • Advise the woman that she may still become pregnant if contraception is not used.
    • See the CKS topic on Contraception for a detailed discussion on the use of contraception in perimenopausal women.

In depth

When should I consider stopping HRT?

  • Women with premature menopause usually take hormone replacement therapy up to the age of the natural menopause (50 years); at that time, treatment is usually reassessed.

What follow-up is required?

Review 3 months after starting hormone replacement therapy (HRT) and once each year thereafter.

  • At 3-months:
    • Check blood pressure, body weight, and assess the effectiveness of treatment; adjust HRT to achieve symptom control.
    • Enquire about any adverse effects and manage appropriately.
  • Once each year:
    • Check blood pressure, effectiveness of treatment and adjust to achieve symptom control.
    • Enquire about adverse effects and manage appropriately.
    • Interrupt treatment with intravaginal oestrogen to re-assess the need for continued use.
    • Discuss the risks and benefits of HRT. Explain that some of the risks (e.g. ovarian cancer) associated with oestrogen-only HRT increase with longer duration of HRT. The risk decreases after stopping HRT.
    • Perform a breast examination if indicated by personal or family history.
    • Encourage breast awareness and participation in the national breast screening programme as appropriate for their age.
    • Pelvic examination is required only if clinically indicated (e.g. if there is unscheduled bleeding, especially if heavy, prolonged, or recurrent).

In depth

When should I refer a women with premature menopause who has started HRT?

  • For women taking cyclical hormone replacement therapy (HRT) refer if:
    • There is a change in pattern of withdrawal bleeds or breakthrough bleeding.
  • For women taking continuous combined HRT or long cycle regimens refer if:
    • Breakthrough bleeding persists for more than 4–6 months after starting therapy.
    • A bleed occurs after amenorrhoea.
  • Refer if there is multiple treatment failure e.g. three or more regimens have been tried.
  • Refer to a team specializing in the management of gynaecological cancer (depending on local arrangements) any persistent or unexplained bleeding after cessation of hormone therapy for 6 weeks.

In depth

Prescriptions

Monthly cyclical combined tablets (low dose oestrogen)

Age from 40 years onwards
Climagest (estradiol 1mg/norethisterone 1mg x12 days)
Climagest 1mg tablets
Take one tablet once a day. (Take in the order shown on the packet).
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £16.69
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should be started on the first day of your period, or at any time if you are no longer having regular periods. If you are changing from a different type of HRT, start these tablets as soon as your previous pack of HRT is finished.
Elleste Duet (estradiol 1mg /norethisterone 1mg x12 days)
Elleste Duet 1mg tablets
Take one tablet once a day. (Take in the order shown on the packet).
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £9.72
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should be started on the first day of your period, or at any time if you are no longer having regular periods. If you are changing from a different type of HRT, start these tablets as soon as your previous pack of HRT is finished.
Femoston (estradiol 1mg/dydrogesterone 10mg x14 days)
Femoston 1/10mg tablets
Take one tablet once a day. (Take in the order shown on the packet).
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £13.47
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should be started between the first and the fifth day of your period, or at any time if you are no longer having regular periods. If you are changing from a different type of HRT, start these tablets as soon as your previous pack of HRT is finished.
Novofem (estradiol 1mg/norethisterone 1mg x12 days)
Novofem tablets
Take one tablet once a day. (Take in the order shown on the packet).
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £13.50
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should be started on the fifth day of your period, or at any time if you are no longer having regular periods If you are changing from a different type of HRT, start these tablets as soon as your previous pack of HRT is finished.
Prempak-C 0.625mcg (oestrogen 625mcg/norgest 150mcg x12days)
Prempak-C 0.625mg tablets
Take one maroon tablet once a day. In addition, take one light brown tablet once a day for 12 days, as shown on the packet.
Supply 1 3-month pack.
Age: from 40 years onwards
NHS cost: £17.67
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should be started on the first day of your period, or at any time if you are no longer having regular periods If you are changing from a different type of HRT, start these tablets as soon as your previous pack of HRT is finished.
Premique Cycle (oestrogen 625mcg/medroxyprogest 10mg x14 days)
Premique Cycle tablets
Take one tablet once a day. (Take in the order shown on the packet).
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £24.14
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should be started on the first day of your period, or at any time if you are no longer having regular periods If you are changing from a different type of HRT, start these tablets as soon as your previous pack of HRT is finished.

Monthly cyclical combined tablets (high dose oestrogen)

Age from 40 years onwards
Climagest (estradiol 2mg/norethisterone 1mg x12 days)
Climagest 2mg tablets
Take one tablet once a day. (Take in the order shown on the packet).
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £16.69
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should be started on the first day of your period, or at any time if you are no longer having regular periods. If you are changing from a different type of HRT, start these tablets as soon as your previous pack of HRT is finished.
Clinorette (estradiol 2mg/norethisterone 1 mg x12 days)
Clinorette tablets
Take one tablet once a day. (Take in the order shown on the packet).
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £9.23
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should be started on the fifth day of your period, or at any time if you are no longer having regular periods. If you are changing from a different type of HRT, start these tablets as soon as your previous pack of HRT is finished.
Elleste Duet (estradiol 2mg/norethisterone 1mg x12 days)
Elleste Duet 2mg tablets
Take one tablet once a day. (Take in the order shown on the packet).
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £9.72
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should be started on the first day of your period, or at any time if you are no longer having regular periods. If you are changing from a different type of HRT, start these tablets as soon as your previous pack of HRT is finished.
Femoston (estradiol 2mg/dydrogesterone 10mg x14 days)
Femoston 2/10mg tablets
Take one tablet once a day. (Take in the order shown on the packet).
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £13.47
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should be started between the first and the fifth day of your period, or at any time if you are no longer having regular periods. If you are changing from a different type of HRT, start these tablets as soon as your previous pack of HRT is finished.
Nuvelle (estradiol 2mg/levonorgestrel 75mcg x12 days)
Nuvelle tablets
Take one tablet once a day. (Take in the order shown on the packet).
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £12.87
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should be started on the fifth day of your period, or at any time if you are no longer having regular periods. If you are changing from a different type of HRT, start these tablets as soon as your previous pack of HRT is finished.
Prempak-C (oestrogen 1.25mg/norgestrel 150mcg x 12 days)
Prempak-C 1.25mg tablets
Take one yellow tablet once a day. In addition, take one light brown tablet once a day for 12 days, as shown on the packet.
Supply 1 3-month pack.
Age: from 40 years onwards
NHS cost: £17.67
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should be started on the first day of your period, or at any time if you are no longer having regular periods If you are changing from a different type of HRT, start these tablets as soon as your previous pack of HRT is finished.

Monthly cyclical combined patches (low dose oestrogen)

Age from 40 years onwards
FemSeven Sequi (estradiol 50mcg/levonorgest 10mcg x14 days)
FemSeven Sequi patches
Apply one patch once a week to the trunk, below the waistline. Apply in the order shown.
Supply 1 3-month pack.
Age: from 40 years onwards
NHS cost: £37.54
Licensed use: yes
Patient information: There are two types of patches in this packet. Use the Phase 1 patches for weeks 1 and 2, and use the Phase 2 patches for weeks 3 and 4. If you have not taken HRT before, start with the Phase 1 patches between the first and the fifth day of your period, or any time if you are no longer having regular periods. If you are changing from a different type of HRT, start these patches as soon as your previous pack of HRT is finished. For full instructions on how to use these patches please read the package insert.
Evorel Sequi (estradiol 50mcg/norethisterone 170mcg x14 days)
Evorel Sequi patches
Apply one patch twice a week to the trunk, below the waistline. Apply in the order shown.
Supply 24 patches.
Age: from 40 years onwards
NHS cost: £30.69
Licensed use: yes
Patient information: There are two types of patches in this packet. Use the Evorel 50 patches for weeks 1 and 2, and use the Evorel Conti patches for weeks 3 and 4. If you have not taken HRT before, start with the Evorel 50 patches between the first and the fifth day of your period, or any time if you are no longer having regular periods. If you are changing from a different type of HRT, start these patches as soon as your previous pack of HRT is finished. For full instructions on how to use these patches please read the package insert.
Fempak 40 (estradiol 40mcg/dydrogesterone 10mg x14 days)
Femapak 40
Apply one patch twice a week to the trunk, below the waistline. In addition, take one tablet once a day for 14 days, as shown on the packet.
Supply 3 one-month packs.
Age: from 40 years onwards
NHS cost: £22.83
Licensed use: yes
Patient information: If you have not taken HRT before, start the patches between the first and the fifth day of your period, or any time if you are no longer having regular periods Take one tablet once a day for the 14 days shown on the packet. It is important that you take the full course of 14 tablets at the right time of the month. If you are changing from a different type of HRT, start the patches as soon as your previous pack of HRT is finished. For full instructions on how to use the patches and tablets, please read the package insert.

Monthly cyclical combined patches (high dose oestrogen)

Age from 40 years onwards
Fempak 80 (estradiol 80mcg/dydrogesterone 10mg x14 days)
Femapak 80
Apply one patch twice a week to the trunk, below the waistline. In addition, take one tablet once a day for 14 days, as shown on the packet.
Supply 3 one-month packs.
Age: from 40 years onwards
NHS cost: £24.18
Licensed use: yes
Patient information: If you have not taken HRT before, start the patches between the first and the fifth day of your period, or any time if you are no longer having regular periods Take one tablet once a day for the 14 days shown on the packet. It is important that you take the full course of 14 tablets at the right time of the month. If you are changing from a different type of HRT, start the patches as soon as your previous pack of HRT is finished. For full instructions on how to use the patches and tablets, please read the package insert.

3 monthly cyclical combined tablets (high dose oestrogen)

Age from 40 years onwards
Tridestra (estradiol 2mg/medroxyprogesterone 20mg)
Tridestra tablets
Take one tablet once a day. (Take in the order shown on the packet).
Supply 91 tablets.
Age: from 40 years onwards
NHS cost: £21.40
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should be started on the fifth day of your period, or at any time if you are no longer having regular periods If you are changing from a different type of HRT, start these tablets as soon as your previous pack of HRT is finished.

Continuous combined tablets (low dose oestrogen)

Age from 40 years onwards
Angeliq (estradiol 1mg/drospirenone 2mg)
Angeliq tablets
Take one tablet daily.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £25.80
Licensed use: yes
Femoston Conti (estradiol 1mg/dydrogesterone 5mg)
Femoston-conti 1mg/5mg tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £13.47
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should not be used unless it is more than 12 months since you had your last period. If you are changing from HRT tablets or patches, start these tablets as soon as your previous pack of HRT is finished. If you are changing from HRT that uses patches with tablets, start these tablets as soon as your previous course of tablets is finished.
Kliovance (estradiol 1mg/norethisterone 500mcg)
Kliovance tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £14.67
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should not be used unless it is more than 12 months since you had your last period. If you are changing from cyclical HRT (monthly bleed while on HRT), start these tablets as soon as your monthly bleed has finished.
Indivina (estradiol 1mg/medroxyprogesterone 2.5mg)
Indivina 1mg/2.5mg tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £21.49
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should not be used unless it is more than 3 years since you had your last period. If you are changing from continuous HRT (no monthly bleeds while on HRT), start these tablets as soon as your previous pack of HRT is finished. If you are changing from cyclical HRT (monthly bleed while on HRT) start these tablets one week after your previous pack of HRT is finished.
Indivina (estradiol 1mg/medroxyprogesterone 5mg)
Indivina 1mg/5mg tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £21.49
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should not be used unless it is more than 3 years since you had your last period. If you are changing from continuous HRT (no monthly bleeds while on HRT), start these tablets as soon as your previous pack of HRT is finished. If you are changing from cyclical HRT (monthly bleed while on HRT) start these tablets one week after your previous pack of HRT is finished.
Premique Low Dose (oestrogen 300mcg/medroxyprogest 1.5mg)
Premique Low Dose tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £29.85
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should not be used unless it is more than 12 months since you had your last period. If you are changing from HRT tablets or patches, start these tablets as soon as your previous pack of HRT is finished.
Premique (oestrogen 625mcg/medroxyprogesterone 5mg)
Premique tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £27.14
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should not be used unless it is more than 12 months since you had your last period. If you are changing from HRT tablets or patches, start these tablets as soon as your previous pack of HRT is finished.

Continuous combined tablets (high dose oestrogen)

Age from 40 years onwards
Climesse (estradiol 2mg/norethisterone 700mcg)
Climesse tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £31.03
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should not be used unless it is more than 12 months since you had your last period. If you are changing from HRT tablets or patches, start these tablets as soon as your previous pack of HRT is finished. If you are changing from HRT that uses patches with tablets, start these tablets as soon as your previous course of tablets is finished.
Elleste Duet Conti (estradiol 2mg /norethisterone 1mg)
Elleste Duet Conti tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £17.97
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should not be used unless it is more than 12 months since you had your last period. If you are changing from cyclical HRT (monthly bleed while on HRT), start these tablets as soon as your monthly bleed has finished.
Indivina (estradiol 2mg/medroxyprogesterone 5mg)
Indivina 2mg/5mg tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £21.49
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should not be used unless it is more than 3 years since you had your last period. If you are changing from continuous HRT (no monthly bleeds while on HRT), start these tablets as soon as your previous pack of HRT is finished. If you are changing from cyclical HRT (monthly bleed while on HRT) start these tablets one week after your previous pack of HRT is finished.
Kliofem (estradiol 2mg/norethisterone 1mg)
Kliofem tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £11.43
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should not be used unless it is more than 12 months since you had your last period. If you are changing from cyclical HRT (monthly bleed while on HRT), start these tablets as soon as your monthly bleed has finished.
Nuvelle Continuous (estradiol 2mg/norethisterone 1mg)
Nuvelle Continuous tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £16.85
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should not be used unless it is more than 12 months since you had your last period. If you are changing from cyclical HRT (monthly bleed while on HRT), start these tablets as soon as your monthly bleed has finished.

Continuous combined patches (low dose oestrogen)

Age from 40 years onwards
FemSeven Conti (estradiol 50mcg/levonorgest 7mcg/24 hour)
FemSeven Conti patches
Apply one patch once a week to the trunk, below the waistline.
Supply 12 patches.
Age: from 40 years onwards
NHS cost: £44.12
Licensed use: yes
Patient information: If you have not taken HRT before, start the patches between the first and the fifth day of your period, or any time if you are no longer having regular periods. If you are changing from a different type of HRT, start the patches as soon as your previous pack of HRT is finished. For full instructions on how to use these patches, please read the package insert.
Evorel Conti (estradiol 50mcg/norethisterone 170mcg/24 hour)
Evorel Conti patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patches.
Age: from 40 years onwards
NHS cost: £35.99
Licensed use: yes
Patient information: If you have not taken HRT before, start the patches between the first and the fifth day of your period, or any time if you are no longer having regular periods. If you are changing from a different type of HRT, start the patches as soon as your previous pack of HRT is finished. For full instructions on how to use these patches, please read the package insert.

Tibolone tablets

Age from 40 years onwards
Tibolone tablets: 2.5mg once a day
Tibolone 2.5mg tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £32.31
Licensed use: yes
Patient information: If you have not taken HRT before, these tablets should not be used unless it is more than 12 months since you had your last period. If you are changing from cyclical HRT (monthly bleed while on HRT), start these tablets as soon as your monthly bleed has finished.

Oestrogen only tablets (low dose)

Age from 40 years onwards
Climaval tablets (estradiol 1mg)
Climaval 1mg tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £9.19
Licensed use: yes
Elleste Solo tablets (estradiol 1mg)
Elleste Solo 1mg tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £5.34
Licensed use: yes
Hormonin tablets (estradiol + estriol + estrone)
Hormonin tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £6.61
Licensed use: yes
Premarin tablets (conjugated oestrogen 625 micrograms)
Premarin 625microgram tablets
Take one tablet daily.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £9.72
Licensed use: yes
Progynova tablets (estradiol 1mg)
Progynova 1mg tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £6.56
Licensed use: yes
Zumenon tablets (estradiol 1mg)
Zumenon 1mg tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £6.89
Licensed use: yes

Oestrogen only tablets (high dose)

Age from 40 years onwards
Bedol tablets (estradiol 2mg)
Bedol 2mg tablets
Take one tablet daily.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £5.07
Licensed use: yes
Climaval tablets (estradiol 2mg)
Climaval 2mg tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £9.19
Licensed use: yes
Elleste Solo tablets (estradiol 2mg)
Elleste Solo 2mg tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £5.34
Licensed use: yes
Hormonin tablets (estradiol + estriol + estrone)
Hormonin tablets
Take two tablets once a day.
Supply 180 tablets.
Age: from 40 years onwards
NHS cost: £13.22
Licensed use: yes
Premarin tablets (conjugated oestrogen 1.25mg)
Premarin 1.25mg tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £13.19
Licensed use: yes
Progynova tablets (estradiol 2mg)
Progynova 2mg tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £7.72
Licensed use: yes
Zumenon tablets (estradiol 2mg)
Zumenon 2mg tablets
Take one tablet once a day.
Supply 84 tablets.
Age: from 40 years onwards
NHS cost: £6.89
Licensed use: yes

Oestrogen only patches (start doses)

Age from 40 years onwards
Elleste Solo MX 40 patch (estradiol 40mcg): apply twice a week
Elleste Solo MX 40 transdermal patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patches.
Age: from 40 years onwards
NHS cost: £15.57
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Estraderm MX 50 patch (estradiol 50mcg): apply twice a week
Estraderm MX 50 patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patches.
Age: from 40 years onwards
NHS cost: £17.22
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Estradot patch (estradiol 50mcg): apply twice a week
Estradot 50micrograms/24hours patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patch.
Age: from 40 years onwards
NHS cost: £15.66
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Evorel 50 patch (estradiol 50mcg): apply twice a week
Evorel 50 patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patches.
Age: from 40 years onwards
NHS cost: £9.72
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Fematrix 40 patch (estradiol 40mcg): apply twice a week
Fematrix 40 patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patches.
Age: from 40 years onwards
NHS cost: £14.85
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
FemSeven 50 patch (estradiol 50mcg): apply once a week
FemSeven 50 patches
Apply one patch once a week to the trunk, below the waistline.
Supply 12 patches.
Age: from 40 years onwards
NHS cost: £18.07
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed once a week, on the same day each week. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Progynova 50 patch (estradiol 50mcg): apply once a week
Progynova TS 50 patches
Apply one patch once a week to the trunk, below the waistline.
Supply 12 patches.
Age: from 40 years onwards
NHS cost: £16.71
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed once a week, on the same day each week. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.

Oestrogen only patches (high dose)

Age from 40 years onwards
Estraderm MX 75 patch (estradiol 75mcg): apply twice a week
Estraderm MX 75 patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patches.
Age: from 40 years onwards
NHS cost: £18.25
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Estradot patch (estradiol 75mcg): apply twice a week
Estradot 75micrograms/24hours patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patch.
Age: from 40 years onwards
NHS cost: £18.09
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Evorel 75 patch (estradiol 75mcg): apply twice a week
Evorel 75 patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patches.
Age: from 40 years onwards
NHS cost: £11.10
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
FemSeven 75 patch (estradiol 75mcg): apply once a week
FemSeven 75 patches
Apply one patch once a week to the trunk, below the waistline.
Supply 12 patches.
Age: from 40 years onwards
NHS cost: £17.46
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed once a week, on the same day each week. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Elleste Solo MX 80 patch (estradiol 80mcg): apply twice a week
Elleste Solo MX 80 transdermal patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patches.
Age: from 40 years onwards
NHS cost: £17.97
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Fematrix 80 patch (estradiol 80mcg): apply twice a week
Fematrix 80 patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patches.
Age: from 40 years onwards
NHS cost: £18.00
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Estraderm MX 100 patch (estradiol 100mcg): apply twice a week
Estraderm MX 100 patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patches.
Age: from 40 years onwards
NHS cost: £18.94
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Estradot patch (estradiol 100mcg): apply twice a week
Estradot 100micrograms/24hours patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patch.
Age: from 40 years onwards
NHS cost: £18.93
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Evorel 100 patch (estradiol 100mcg):apply twice a week
Evorel 100 patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patches.
Age: from 40 years onwards
NHS cost: £11.52
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
FemSeven 100 patch (estradiol 100mcg): apply twice a week
FemSeven 100 patches
Apply one patch once a week to the trunk, below the waistline.
Supply 12 patches.
Age: from 40 years onwards
NHS cost: £18.21
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed once a week, on the same day each week. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Progynova TS 100 patch (estradiol 100mcg): apply once a week
Progynova TS 100 patches
Apply one patch once a week to the trunk, below the waistline.
Supply 12 patches.
Age: from 40 years onwards
NHS cost: £19.68
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed once a week, on the same day each week. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.

Oestrogen only patches (low dose)

Age from 40 years onwards
Estraderm MX 25 patch (estradiol 25mcg): apply twice a week
Estraderm MX 25 patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patches.
Age: from 40 years onwards
NHS cost: £17.15
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Estraderm TTS 25 patch (estradiol 25mcg): apply twice a week
Estraderm TTS 25 patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patches.
Age: from 40 years onwards
NHS cost: £22.36
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Estradot patch (estradiol 25mcg): apply twice a week
Estradot 25micrograms/24hours patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patch.
Age: from 40 years onwards
NHS cost: £15.60
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Evorel 25 patch (estradiol 25mcg): apply twice a week
Evorel 25 patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patches.
Age: from 40 years onwards
NHS cost: £8.58
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.
Estradot patch (estradiol 37.5mcg): apply twice a week
Estradot 37.5micrograms/24hours patches
Apply one patch twice a week to the trunk, below the waistline.
Supply 24 patch.
Age: from 40 years onwards
NHS cost: £15.60
Licensed use: yes
Patient information: Stick one patch onto a clean, dry, hairless area of skin below the waist. The buttocks are often the best place to stick patches. Patches can also be stuck on the lower back, hip, abdomen or upper thigh. Never put a patch on or near the breasts. The patch needs to be changed twice a week. It is usually easier to change your patch on the same days each week e.g. Monday and Thursday. When you change your patch, always put the new patch on a fresh area of skin. For full instructions on how to use these patches, please read the package insert.

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