HRT preparations: for Perimenopause

Please note: Patients should consult a health professional to decide on the appropriate treatment option to be prescribed.

PERI-MENOPAUSAL SEQUENTIAL COMBINED THERAPY

Used in women with an intact uterus (womb) who are not yet postmenopausal, i.e. have some periods due to continuing ovarian function. Products contain daily estrogen and cyclical progestogen.
Progestogens which can be used cyclically are of 3 main types:

1. Testosterone derived - Norgestrel, Norethisterone acetate and Levonorgestrel.
2. Less testosterone related - Medroxyprogesterone acetate(MPA).
3. Least testosterone related - Dydrogesterone and Micronised progesterone (Utrogestan).

Side effects are often experienced during the progestogen phase of treatment and can be reduced by using a product containing a different type or route of progestogen.

Prices are for 84 tablets, ie 3 months.

a. Low dose - recommended starting dose.

b. Medium dose -

All the above cause a monthly bleed in 85% of patients.

Long cycle treatment - useful in perimenopausal patients who are having infrequent periods, but may not be sufficiently post menopausal to offer continuous combined therapy to, and will confer a bleed every 3 months. Available is:

Prices are for 1 month.

Medium Dose

Tailor made sequential combined therapy is useful in patients who develop PMS type symptoms on a fixed HRT, particularly if the regime contains a progestogen of testosterone derivation (norethisterone, norgestrel and levonorgestrel). FEMOSTON, PREMIQUE CYCLE & TRIDESTRA are fixed preparations using the less androgenic medroxyprogesterone acetate or dydrogesterone.