Hysterectomised patients

There is a large variation in the individual's response to different types and routes of estrogen for symptom control. The products are divided into groups according to dose and route of estrogen but for doses, these divisions are arbitrary. Products within the same dosage group are not exactly equivalent. Changes within the same group to a different type of estrogen may have a better effect on symptom control.
The products marked * are licensed for prevention and / or treatment of osteoporosis.
Prices are for 28 days supply in euros.

a. Medium dose

b. Higher dose

NON-ORAL

a. Patches-can be matrix (M) or reservoir (R) Matrix tend to cause less skin irritation and adhere better. Patches can be changed once or twice weekly.

Low dose

Medium dose

High dose

Higher dose

b. Gels - are useful if transdermal treatment is the option preferred but skin irritation occurs with patches.

c. Implants - usually used when symptoms are not controlled by other preparations.
Available are 25, 50 and 100 mg implants. Current recommendation is to use lowest effective dose.

All estrogen only preparations can be used in non-hysterectomised patients as long as an appropriate progestogen is prescribed in addition.