Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Hurdity on August 19, 2025, 07:29:39 PM
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Hi all
I haven't been on here for months because I've had so much on - not time even to read the weekly MM newsletter that comes into my inbox BUT just by complete chance TODAY decided to have a quick read of the newsletter that came through this morning - and I couldn't believe my eyes!
Here is what it says in the newsletter:
"A "new" progestogen has been launched called Nalvee. Previously known as Duphaston, Nalvee provides dydrogesterone, which is a great progestogen with a better protective effect on the endometrium than micronised progesterone. It has, generally less side effects than some progestogens, and has a similar risk profile to micronised progesterone for breast risk effect."
and here is the Press Release by Gedeon-Richter UK:https://pharmatimes.com/news/gedeon-richter-launches-nalvee-in-uk-to-expand-hrt-options-for-menopause/
I had an idea this was on the cards because I had read that the rights to Dupaston had been acquired some time ago by Theramex and wondered if this meant making it available in UK - but instead a different company has launched their own product.
Since I am now coming to the end of my latest Utrogestan cycle and being thoroughly fed up with it (in my 70's) I am really excited that this might make a difference to staying on HRT rather than gradually winding down (given my age).
On this forum we have been talking at times wistfully and at times angrily about Duphaston and dydrogesterone and how it could revolutionise women's adherence to HRT - and tolerance to progestogens - if it was still available in UK. Here it now is! Not a magic bullet for everyone, and I might eat my words after trying it - but I intend to try to get hold of it for my next cycle! It will be the end of my 17 year nil-by-mouth HRT regime - but hopefully will be worth it!
For those who want to read a bit more here is the medical entry:
https://www.medicines.org.uk/emc/product/101122/smpc
I did a search on the forum and it hasn't been mentioned yet so the news hasn't yet got through.
Hopefully it will make a real difference to many of us who are not happy with the current choices of progestogen, but want to be as near to bio-identical as possible.
Hope everyone's well :)
Hurdity x
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Thanks for sharing this!
I do hope word gets out and it doesn't disappear due to "lack of demand" because nobody knows about it!
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I have been searching on this forum too for anyone’s experience of it :)
I’ll be following your trial with interest!
Fingers crossed :)
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There are a lot of posts on Instagram about Nalvee on the pages of menopause doctors / specialists. Instagram seems to be the place where up to date things are discussed.
https://m.youtube.com/watch?v=0nzCoaziaJI
Interesting watch on You Tube about Nalvee. It says towards the end that it’s not available on NHS yet but can be obtained privately but is very expensive.
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I have been searching on this forum too for anyone’s experience of it :)
I’ll be following your trial with interest!
Fingers crossed :)
I'll have to get hold of it first - hoping my great gynae specialist GP will agree to prescribing it!
Hurdity x
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There are a lot of posts on Instagram about Nalvee on the pages of menopause doctors / specialists. Instagram seems to be the place where up to date things are discussed.
https://m.youtube.com/watch?v=0nzCoaziaJI
Interesting watch on You Tube about Nalvee. It says towards the end that it’s not available on NHS yet but can be obtained privately but is very expensive.
Hmm that's interesting. I thought ALL (licensed) medicines listed on EMC were available on NHS? I must admit I assumed that because it featured in the MM newsletter that it was available on NHS.
I don't follow any Instagram pages of specialists - who would you recommend - (I have too much to read generally as it is!)?
Well I certainly don't want to have to go privately to obtain it.....
Oh dear well that puts the dampers on things somewhat!!!!
Hurdity x
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...however on further googling I found this:
https://dmd-browser.nhsbsa.nhs.uk/ampp/view/210500?ref=
- listed on an NHS related website.
...and it is also listed under various formularies throughout UK, but as expected - for exceptional use or not yet discussed, but this is the case for many of the HRT products many of us are using - they are not the first product that is recommended but you have to argue your case....
Hurdity x
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Hi Hurdity. I've just listened again to the You Tube clip and the doctor says that she doesn't think it's on the NHS yet. I saw on the Norfolk formulary website that it's not yet available and on my local formulary it's not mentioned at all. So who knows?
Just read on The Menopause Support Network Facebook Page ( Diane DAnzebrink ) that it is available but depends on your local formulary.
Good people to follow on Instagram....Diane Danzebrink, Dr Louise Newson, mre fund, Dr Naomi potter, hormone equilibrium, Dr Sarah Molly Ball, Manchester Menopause Hive. There's too many to name really.
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Hi again Dotty
Yes I just listened to the youtube interview and the doc admitted she didn't actually know.
Re formularies - I can see it may take a while for it to be discussed and listed even as a restricted formulary item, but in theory it should be available. It will be interesting to test this out by trying to get hold of it - but maybe I'll wait until I next need to renew my Utrogestan, so put up with it for one more cycle (hopefully the last!) - to give them a bit more time.
Thanks for the recommendations. Yeah - don't have time to read all of those but maybe will follow a few! You're obivously keeping well up to date - unlike me!!!
Hurdity x
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Hello ladies.
I have learned that just because a treatment is available or recommended there is no guarantee that you will get your mitts on it lol!
I was with Newson Health and using Cyclogest pessaries as my progesterone.
I heard that my surgery had a Menopause Nurse so I moved back to my GP for HRT and was told that Cyclogest was not available in Primary Care even though I know other ladies were getting it from their GPs.
I was subsequently referred to an NHS consultant who recommended Lutigest but yet again my GP surgery refused to prescribe it.
I hope the ladies who want to try this treatment are given the opportunity and hopefully they won't have a fight on their hands.
Wishing you well ladies.
K.
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Thanks for sharing it Hurdity, I literally just did a Google search for it after reading an older post on here that it wasn’t available (back then). I’ve worked out that my remaining symptoms are very likely linked to progesterone because I seem very sensitive to it. I’m definitely going to mention it to my GP soon because I think it’s worth a try if only to address these pesky side effects!
I’ve also read that it can be provided on the NHS as it was added to the HRT PPC from 1 September.
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Anyone managed to fet hold of this yet? I contacted my local formulary and they said they had no plans to add it and my GP will not prescribe it until it is added.
I have asked a private consultant but they are not able to give me any idea of costs involved.
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NHS availability
Dydrogesterone is available on the NHS. Specifically, Nalvee 10 mg tablets are listed in the Specialist Pharmacy Service’s (SPS) available HRT products.
It has been added to the list of medicines covered by the Hormone Replacement Therapy Prepayment Certificate (HRT PPC) from 1 September 2025. That means people using HRT can include dydrogesterone under the HRT PPC scheme.
Some local NHS formularies currently mark dydrogesterone (e.g. Duphaston) as non-formulary (i.e. not routinely recommended or available in certain Trusts or regions) for some uses.
So yes, it can be prescribed under the NHS for HRT/progestogen needs, but how easy it is to access may depend on your local area, the particular product, and whether the prescriber uses that option.
Private cost
The cost of dydrogesterone privately depends on dosage, quantity, brand, and whether it’s part of a combined HRT preparation. Some examples:
Duphaston 10 mg, 10 tablets: around £11.69 from one online private pharmacy.
A brand-combination HRT like Femoston (estradiol + dydrogesterone) 84 tablets: about £39.99 from a private pharmacy.
For larger packs or higher quantities, the per-tablet cost tends to fall (as is common with medications). For example, Femoston costs from “as little as 43p a tablet” in some private settings.
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I can get a private prescription for Nalvee - but does anybody know where it's available yet?
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It's readily available in Portugal and I bought some over the counter in a Pharmacy. You don't need a prescription for progesterone in a lot of places. It cost €9.85 for a box of 42 tablets - it's actually called Duphaston in the EU.
You can get it easily in Ireland too but you would need a prescription. Obviously this is not much help unless you are in or travelling to Portugal or Ireland.
I don't know why it's so difficult to get hold of in the UK because it's not even expensive.
On a personal note, I was going to try the Duphaston having bought it but I've since changed my mind because it's not a good option for people with brainstem auras. Apparently it's not as stable or as good at blocking FSH and LH as Cerazette and compounded progesterone because it works differently on the brain and pituitary gland. Utrogestan is even worse and very unstable which is probably why so many women have problems with it. I should have realised because I briefly tried Femoston and it gave me endless migraine auras but I (wrongly) put it down to the oral oestrogen.
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Today I’ve just had two consultations, one with a private menopause service, the other was my GP: both inform me that Nalvee is “licensed” for sequential/cyclical use ONLY, and not continuous, therefore they are unwilling to prescribe to post-menopausal women on a continuous regime because that would be “off license”. Which is illogical to my thinking because Femostan 2/10 can be taken continuously and is not limited to peri-menopausal women as I understood it. Further, Nalvee contains exactly the same dose of dydrogesterone as Femostan, which is 10mg. This is so frustrating! I don’t know who else I can turn to, I don’t feel I can realistically reduce my 100 patch so I can get away with less progesterone, as I feel ill when I do that. I feel stuck on micronised progesterone, which I am clearly sensitive to. I wish the mirena had worked for me :(
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Furyan, that sounds like complete nonsense and a ridiculous excuse. There is no reason why they can't prescribe it for continuous use or show some initiative and prescribe it off licence. Are they hamstrung by NHS/NICE rules perhaps? Did they give you a good reason why they can't prescribe off licence?
I was reading about a problem with the NHS and pharmaceutical companies today (partly over costs I think) and there seems to be a problem over drug licensing in the UK too. I suppose things have changed since you left the EMA. I'm sure someone on here can fill everyone in on that better than I can.
Have you tried Cerazette (desogestrel)? It would probably be a very good substitute unless you have a very specific reason for wanting to try dydrogesterone.
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MayB check directly with the Manufacturer for clarification?
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Furyan, that sounds like complete nonsense and a ridiculous excuse. There is no reason why they can't prescribe it for continuous use or show some initiative and prescribe it off licence. Are they hamstrung by NHS/NICE rules perhaps? Did they give you a good reason why they can't prescribe off licence?
I was reading about a problem with the NHS and pharmaceutical companies today (partly over costs I think) and there seems to be a problem over drug licensing in the UK too. I suppose things have changed since you left the EMA. I'm sure someone on here can fill everyone in on that better than I can.
Have you tried Cerazette (desogestrel)? It would probably be a very good substitute unless you have a very specific reason for wanting to try dydrogesterone.
I did get paranoid wondering if I was being unreasonable because how closed to the idea they both were. They only said it’s to do with what the medicines are licensed for but neither could explain why they didn’t feel able to prescribe despite happily giving it to women via Femostan on a continuous basis! The GP said she would refer me to the NHS menopause clinic but it doesn’t appear that she has - I read the ‘referral’ letter which only asked whether Slynd could be prescribed “off licence” instead. Sooooo frustrating.
The reason I’m keen to try Nalvee is because I’m extremely sensitive to micronised progesterone (much like when I was pregnant) and after reading about it in a post here I did a bit of digging around to find some clinical research on it. It looks to have a very favourable profile regarding stability and side effects. It’s actually been around for decades but was taken off the market for “commercial” reasons. It’s a synthetic that most resembles our own progesterone but is taken in significantly lower doses than utro, which is why I wondered whether it’s worth trying above all.
I was goung to look at cerazette too - just that dydrogesterone looks so attractive…
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MayB check directly with the Manufacturer for clarification?
What a good idea CLKD, I might just do this now. Makes my blood boil because there seems to be zero initiative or understanding when it comes to women’s care and we get such crap service as a result - whilst continuing to suffer with symptoms. I almost came away from the GP conversation feeling guilty for struggling with progesterone. Common sense tells me it was just her own lack of expertise but still, I felt bad.
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Furyan, I must admit I thought dydrogesterone sounded like a good option for me because stability is key considering I suffer with migraine auras. I did try Femoston some time ago and it was a disaster because I had endless migraine auras but I wrongly put it down to the oral oestrogen content.
Having spent time researching dydrogesterone before taking the plunge and giving it a try, I'm afraid in my case it's not going to fly because I need to suppress FSH and LH to prevent migraine auras. The Mirena coil (levonorgestrel), Slynd (drospirenone) and Duphaston (dydrogesterone) do not adequately close down the release of gonadotropin-releasing hormones so it doesn't create the stable hormone environment needed to prevent migraine auras. Interestingly I found compounded progesterone worked extremely well. In my case, norethisterone is the absolute worst for instability closely followed by micronised progesterone and I'm convinced that's why women have so many side effects with Utrogestan.
Obviously most women don't have migraine auras but I think it's possibly the same mechanism that sets off some of the other progesterone issues that are frequently discussed on here.
I think you can buy Cerazette without a prescription from a pharmacy in the UK. I really would give it a try if you can. I don't take the recommended dose, I take 75mcg alongside progesterone gel and it works well.
I hope that helps.
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Mary G, I’ve seen you share about your migraine auras and every time it strikes me just how much some ladies must bear to get the right type of HRT ON TOP of the symptoms! Sounds like you tried more progestins than me so I appreciate you sharing your experience. Very interesting which types of progestins suppress our bodies and which don’t - I’m recovering from adrenal fatigue among a couple things and I don’t want to suppress my body’s own natural production of hormones because, at some point, I’d like to think I could wean off very slowly to allow my adrenals to take over as they were meant to. If cerazette does suppress our own hormone production, that could be an issue for when I eventually wean off the whole lot - well, I can only hope I’ll be able to do this, one day…
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I managed to speak to someone at the manufacturer, who advised that she cannot give definitive information about prescribing guidelines to members of the public, only medical professionals. However, she also mentioned that “any” medicine, including Nalvee, can be prescribed off label subject to the prescriber’s discretion. She has known Nalvee to be prescribed on a continuous basis to women for whom it was appropriate. I’m assuming this was without adverse effect if I understood what she ‘was not’ saying if you understand…
So - what I took from this is that some medical professionals, whilst also acutely aware of this information, unfortunately may not be so willing to use their medical ‘discretion’, for whatever reasons, to help a broader pool of women. I’m obviously going to have to search now for one who might be willing but it could be an uphill struggle whilst Nalvee is new to the UK market. My own private menopause consultant said he is not keen on synthetics because of the increased risk of breast cancer. He didn’t mention any concerns about the multiple risks of obesity, allergy-type breathlessness and enlarged painful breasts that’s being caused by the micronised progesterone though…
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Furyan, I think I would find a better menopause specialist or take a trip to Portugal. I still can't believe how easy it was to just walk into a pharmacy and buy it over the counter without a prescription. I didn't even have to order it for the next day! It's a pity I won't be able to try it but for me it's not worth the risk.
The fanfare around the launch of dydrogesterone in the UK has turned into a washout because of mindless guidelines. I would imagine it's the same group of inept people who still refuse to licence Utrogestan for vaginal use when the rest of the world has forever.
I assume you spoke to both doctors about your adrenaline issues and it didn't budge them. The risk of breast cancer from synthetic progesterone is very, very small and perhaps it would be reduced further if they didn't dose women up to the eyeballs with it. I take 75mcg Cerazette every day alongside progesterone gel and I don't get any breast pain but if I increased the Cerazette dose to the NHS approved 150mcg dose I would definitely have breast pain and bloating. I don't need a high dose like that because I have regular scans and the last one registered a womb lining of 1mm. God knows what it would have been with twice the dose, I probably would have run into problems.
It's interesting you mentioned Utrogestan and breathlessness, I used to get that after taking it at night.
What are your plans now?
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Mary G - if I wasn’t feeling so frustrated at the ludicrous and frankly illogical thinking that I’ve met up against with this and other things I’d smile at the way you describe them.
It took me a while to figure out it was the progesterone causing severe breathlessness (like painful lungs) because it was only when I went back to it after trying mirena and Tibolone I realised the direct link that was clear as daylight to me. I’ve mentioned it to several doctors both before and after making the link and each one looked at me baffled as though they were questioning my reality - one said she had never heard of progesterone causing breathlessness. I get it within a couple hours of taking each dose as I split it between morning and evening - along with fast heart rate. This is one of three side effects that I can’t live with as it’s debilitating.
I’ve heard back from a private menopause clinic today who said they are happy to consider prescribing off label on a continuous basis, but to be aware it’s expensive on private prescription. Bearing in mind I have to shell out for the consultation itself. I’m minded to book, pay and review with them and take it from there. While it’s a positive, it’s like a double edged sword considering the high price it comes at. Not to mention how grossly unfair (criminal even) it is for women to have to pay through the roof for standard care that they should be getting on the NHS. Women are being milked left, right and centre over their care - I should be in Portugal!
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It's an absolute racket isn't it. Anyone would think you were trying to get hold of crack cocaine, not legal medication. We are talking about something that costs €9.85 for a box of 42 tablets and yet women are having to pay high fees for a consultation and then a hefty amount for the private prescription. Any idea what we are talking about cost wise? I know most menopause specialists charge £300 ish for the initial consultation.
I've got a box up for grabs so I'll send you a PM.
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I just asked my GP if dydrogesterone was available to prescribe yet and he has kindly prescribed it this morning on a continuous basis. I'll let you know how I get on.
I'm currently on Femseven Conti but I swear all the oestrogen is downloaded in the first couple of days! Plus, I can't put them on my abdomen or I get a rash, so they have to go on hips, bum, top of thigh, with a Tegaderm on top to keep them in place.
I loved utrogestan but couldn't deal with the appalling constipation if swallowed, nor the vaginal irritation if used vaginally.
Huge thanks to Hurdity for bringing it onto the radar, and to Emma for enabling me to check if it's on the formulary for my county - didn't know about this process, so it helped me to check before I requested it. :-*
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It's an absolute racket isn't it. Anyone would think you were trying to get hold of crack cocaine, not legal medication. We are talking about something that costs €9.85 for a box of 42 tablets and yet women are having to pay high fees for a consultation and then a hefty amount for the private prescription. Any idea what we are talking about cost wise? I know most menopause specialists charge £300 ish for the initial consultation.
I've got a box up for grabs so I'll send you a PM.
Thanks Mary G, I just PM’d you xx
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I just asked my GP if dydrogesterone was available to prescribe yet and he has kindly prescribed it this morning on a continuous basis. I'll let you know how I get on.
I'm currently on Femseven Conti but I swear all the oestrogen is downloaded in the first couple of days! Plus, I can't put them on my abdomen or I get a rash, so they have to go on hips, bum, top of thigh, with a Tegaderm on top to keep them in place.
I loved utrogestan but couldn't deal with the appalling constipation if swallowed, nor the vaginal irritation if used vaginally.
Huge thanks to Hurdity for bringing it onto the radar, and to Emma for enabling me to check if it's on the formulary for my county - didn't know about this process, so it helped me to check before I requested it. :-*
That’s amazing that you got prescribed it at GP level, well done for going for it! On the other hand, it makes me angry because it just goes to show how dreadfully unfair this is. I have to pay the best part of 400£ to get it right now. That part is so sad…
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I just asked my GP if dydrogesterone was available to prescribe yet and he has kindly prescribed it this morning on a continuous basis. I'll let you know how I get on.
I'm currently on Femseven Conti but I swear all the oestrogen is downloaded in the first couple of days! Plus, I can't put them on my abdomen or I get a rash, so they have to go on hips, bum, top of thigh, with a Tegaderm on top to keep them in place.
I loved utrogestan but couldn't deal with the appalling constipation if swallowed, nor the vaginal irritation if used vaginally.
Huge thanks to Hurdity for bringing it onto the radar, and to Emma for enabling me to check if it's on the formulary for my county - didn't know about this process, so it helped me to check before I requested it. :-*
That’s amazing that you got prescribed it at GP level, well done for going for it! On the other hand, it makes me angry because it just goes to show how dreadfully unfair this is. I have to pay the best part of 400£ to get it right now. That part is so sad…
I know, I'm sorry you have this to deal with. It's really weird. You'd think, being a national system, that everyone would get the same medications as standard. ???
I did get quizzed on whether I really needed both Ovestin and Vagifem today. I used to have to argue for that on a regular basis. It's all much harder work than it should be, although until recently they'd have cut off my HRT, as I'm 61.
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I am so fed up with the NHS at the moment. I tried to get dydrogesterone but was told it will not be available in my area for a long time as the local Formulary is not even reviewing it and my GP will not prescribe anything that they don't list. Ended up getting the Mirena instead as they insisted it would only have local side effects but now dealing with bad systemic side effects, wondering when to give up and go private for dydrogesterone.
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Hi,
I am also very interested in trying this. I have also had problems with progesterone. Currently on Cyclogest (private prescription).
Just saw that Nalvee is now covered by the HRT prepayment certificate!
https://cpe.org.uk/our-news/dydrogesterone-10mg-tablets-nalvee-added-to-the-hrt-ppc-medicines-list/
I'm going to ask for this at my GP appointment later this week. Has anyone else managed to get a prescription for it?
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Has anyone had it prescribed yet? I'm off to get a script tomorrow from private GP but it's where to go to get it??
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Has anyone had it prescribed yet? I'm off to get a script tomorrow from private GP but it's where to go to get it??
Hi - I just got a private prescription as GP is also dragging their feet referring me to an NHS menopause clinic. Any pharmacy should be able to order it once you have a prescription. Two local chemists told me they can get it ok.
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Yes ordered, thank you. Hope you get on with it 🙏
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I have been prescribed it, but my pharmacy have found it to be out of stock at the supplier.
Bit frustrating, really :-\
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Hello,
Just to let you all know that I have managed to get a prescription for Nalvee/Dydrogesterone from my GP! It was difficult to find it in the chemist but managed to get from Boots in the end.
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Hello,
Just to let you all know that I have managed to get a prescription for Nalvee/Dydrogesterone from my GP! It was difficult to find it in the chemist but managed to get from Boots in the end.
Oh, that's hopeful, thanks lizzy76. With a bit of luck my local Boots will get it soon!
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Hurdity I've sent you a private message xx
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Hi all
I haven't been on here for months because I've had so much on - not time even to read the weekly MM newsletter that comes into my inbox BUT just by complete chance TODAY decided to have a quick read of the newsletter that came through this morning - and I couldn't believe my eyes!
Here is what it says in the newsletter:
"A "new" progestogen has been launched called Nalvee. Previously known as Duphaston, Nalvee provides dydrogesterone, which is a great progestogen with a better protective effect on the endometrium than micronised progesterone. It has, generally less side effects than some progestogens, and has a similar risk profile to micronised progesterone for breast risk effect."
and here is the Press Release by Gedeon-Richter UK:https://pharmatimes.com/news/gedeon-richter-launches-nalvee-in-uk-to-expand-hrt-options-for-menopause/
I had an idea this was on the cards because I had read that the rights to Dupaston had been acquired some time ago by Theramex and wondered if this meant making it available in UK - but instead a different company has launched their own product.
Since I am now coming to the end of my latest Utrogestan cycle and being thoroughly fed up with it (in my 70's) I am really excited that this might make a difference to staying on HRT rather than gradually winding down (given my age).
On this forum we have been talking at times wistfully and at times angrily about Duphaston and dydrogesterone and how it could revolutionise women's adherence to HRT - and tolerance to progestogens - if it was still available in UK. Here it now is! Not a magic bullet for everyone, and I might eat my words after trying it - but I intend to try to get hold of it for my next cycle! It will be the end of my 17 year nil-by-mouth HRT regime - but hopefully will be worth it!
For those who want to read a bit more here is the medical entry:
https://www.medicines.org.uk/emc/product/101122/smpc
I did a search on the forum and it hasn't been mentioned yet so the news hasn't yet got through.
Hopefully it will make a real difference to many of us who are not happy with the current choices of progestogen, but want to be as near to bio-identical as possible.
Hope everyone's well :)
Hurdity x
I've sent you a private message please help xxx
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Hurdity!!!!! I got accepted for Navee! Pick it up tomorrow from chemist!!!! X̌xxx
Abd I am willing to take it continuously because I need my ovaries shut down....when they say off licence you can still do this ....I've seen this with other medicines used off licence fir this n that x
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Hi Vicky - only just seen this and have just answered your message
Hurdity x
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So I've been on Nalvee for a week- very early days but not much in the way of side effects so far, except some short-lived drowsiness.
One thing I have noticed is that it takes away the desire to overeat, so with a bit of luck I'll get some weight off.
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So I've been on nalvee 10 days and I started a bleed yesterday....should I keep taking for prescribed 14 days or stop and let bleed come? Is it normal to get bleeding when you switch? Feel terrible tbh
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So I've been on Nalvee for a week- very early days but not much in the way of side effects so far, except some short-lived drowsiness.
One thing I have noticed is that it takes away the desire to overeat, so with a bit of luck I'll get some weight off.
As it turns out, I have anxiety, insomnia, worse acid reflux than normal...ooh, and violent pooping caused by Nalvee.
Sooooo, back to Femseven Conti and feeling better within a couple of hours. Just requesting to change my prescription back 🙏
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@Cherry - sorry to hear you’ve had this reaction to Nalvee. Could it be a temporary reaction to it? The body can sometimes do that temporarily after a change, even if it is the right one. Maybe you need to give it more time…