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Home Formulary 6.0 Endocrine 6.4 Sex hormones 6.4.1.1 Hormone replacement therapy (HRT) for menopausal symptoms 6.4.1.1b Women who have had a hysterectomy or who have a Mirena® Intra Uterine System (ISU) in situ

6.4.1.1b Women who have had a hysterectomy or who have a Mirena® Intra Uterine System (ISU) in situ

Unopposed oestrogens (oral)

ChoiceDrug
1st choice Elleste-Solo® 1mg, 2mg (estradiol) tablets

Unopposed oestrogens (transdermal)

ChoiceDrug
1st choiceEvorel® patches 50micrograms (or 25micrograms, 75micrograms, 100micrograms/24 hours) (estradiol)

Unopposed oestrogens (gel)

ChoiceDrug
1st choiceOestrogel® 0.06% gel

 

Prescribing Notes

  • HRT preparations should be brand prescribed to aid product identification
  • It is recommended that the lowest dose of HRT based on relieving menopausal symptoms should be prescribed
  • Women with an early menopause (<45 years), especially if surgically induced, require the higher dose of oestrogen to control their vasomotor symptoms and for bone protection
  • Mirena® is licensed for 4 years for endometrial protection during oestrogen replacement therapy (i.e. Mirena® provides the progestogen component of HRT). In practice, it is used for up to 5 years, providing the woman is not experiencing bleeding

Preparations for vaginal atrophy

See section 7.2.1

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