TYPES OF HRT AVAILABLE

Both estrogen-only and estrogen in combination with progesterone HRT preparations are available.  They may be in oral, transdermal or topical forms.

Estrogen-only replacement therapy is used only in women who have had their uterus removed.  In women with an intact uterus, the combination forms should be taken instead, either in a cyclical fashion (in which there will be regular withdrawal bleeding) or in a continuous fashion (in which there will be no bleeding).

Women with conditions such as a history of breast and endometrial cancer, abnormal vaginal bleeding, clotting disorders, history of stroke and liver disease, should generally not be on HRTs.

Speak to your doctor about your suitability of starting HRT if you have severe menopausal symptoms.

SYSTEMIC THERAPY

Estrogen-Only (Oral Preparations)

• Conjugated Equine Estrogen (Premarin)
• Estradiol (Estrofem)
• Estradiol Valerate (Progynova)

Estrogen-Only (Transdermal Preparations)

• Estradiol patch (Estraderm)
• Estrogel
• Estradiol Hemihydrate (Estreva gel)

Cyclical Combined Therapies (oral)

• Estradiol valerate and norgestrel (Progyluton)
• Estradiol valerate and cyproterone aceate (Climens)
• Conjugated equine estrogen and norgestrel (Prempak-C)
• Conjugated equine estrogen and medroxyprogesterone acetate (Premelle cycle 5)
• Estradiol and dydrogesterone (Femoston)
• Estradiol and norethisterone acetate (Trisequens)

Continuous Combined Therapies (oral)

• Conjugated equine estrogen and medroxyprogesterone acetate (Premelle 5 or Premelle 2.5)
• Estradiol and norethisterone acetate (Kliogest or Activelle)

LOCAL THERAPY

These hormonal preparations are used in postmenopausal women with symptoms isolated to the urogenital tract.

• Estradiol pessary (Vagifem)
• Conjugated equine estrogen cream (Premarin cream)
• Colpotrophine pessary
• Colpotrophine cream
• Estradiol ring (Estring)

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