Elleste Duet

Elleste Duet is a type of sequential (or cyclical) HRT that’s typically recommended for women who have menopausal symptoms and are still experiencing their period. It contains synthetic forms of oestrogen and progesterone.

The oestrogen helps to regulate hot flushes, night sweats and other menopausal symptoms, whilst the progesterone reduces your risk of developing womb (or endometrial) cancer. ^[1] The oestrogen can also provide protection from osteoporosis, which can affect some women post-menopause.

The menopause causes the ovaries to produce less oestrogen, and this reduction triggers certain symptoms in the body, like trouble sleeping, lower sex drive, hot flushes, vaginal dryness and discomfort during sex, low mood and anxiety, and night sweats.

The oestrogen in combined HRT compensates for the decline in naturally occurring oestrogen in the body, and can help to ease these symptoms. It’s understood that oestrogens in HRT can reduce the frequency of menopausal symptoms by 75%. ^[2]

If you haven’t had a hysterectomy, the oestrogen in combined HRT can make the lining of the womb thicker than normal, and this may lead to endometrial cancer. The progesterone in Elleste Duet helps to restrict this from happening, and greatly limits the cancer risk.

And just to bring today’s science lecture to a close: the reduction in oestrogen in the body during the menopause puts the bones at greater risk of breaking or thinning. The oestrogen in combined HRT supplements this, and helps to prevent osteoporosis.

If you’re getting menopausal symptoms and are continuing to have periods, combined sequential HRT options like Elleste Duet and Evorel Sequi patches are usually the recommended treatments.

Like all HRT, combined sequential options can have side effects, and aren’t always suitable if you’re already taking certain medications, or if you have a particular health condition. Our clinician will assess which treatments are best for you as part of your consultation with us.

If you’re postmenopausal, continuous combined HRT options like Indivina and Evorel Conti patches are typically the best route. You usually fall into the ‘postmenopausal’ category if you’ve not had a period for one year. You take continuous combined HRT every day, without a break.

Oestrogen-only treatments such as Elleste Solo and Estradot patches are advisable for women who have had a total hysterectomy (so the whole womb including the cervix has been removed).

Different HRT products can vary from one to the next in terms of the quantity of hormones in them, so your sensitivity to hormone levels can be another important factor in which specific HRT is the right one for you.

What doses of Elleste Duet are available?

Elleste Duet is available in two doses: a low dose (1mg estradiol and 1mg norethisterone) and a medium dose (2mg estradiol and 1mg norethisterone).

You’ll usually be prescribed the lowest hormonal dose for the shortest period of time to begin with, to see how your body responds to the hormones. If you think that the hormonal dose is too low, you should discuss adjusting it with our clinician.

Take Elleste Duet as instructed by your prescriber. If you think that the dose you have been prescribed is either not strong enough or too strong, let our clinician know. They may decide to adjust your dose, or can discuss alternative treatment options with you where necessary.

If you’re still getting regular periods, you should start taking Elleste Duet on the first day of bleeding. If you aren’t having regular periods, you can start using Elleste Duet immediately.

Take one tablet every day at the same time. Swallow the tablets whole, with water. You should follow the direction of the arrows on the pack and take a tablet each day until the pack is empty.

If you’re using the 1mg dose, the first day should be above the white tablet, which has the start arrow beside it. The 1mg pack has 16 white tablets and 12 light green tablets in it. You should start with the white tablets.

If you’re taking the 2mg dose, the first day should be above the orange tablet which has the start arrow next to it. The 2mg pack contains 16 orange tablets and 12 grey tablets. Start with the orange tablets.

Once you have finished your first strip, start a new strip the following day. Apply a fresh sticker to your new foil strip. To make it easier to remember taking your tablet, there are stickers in the pack with the days of the week printed on them. So for instance, if you’re starting to take the tablets on a Friday, use the sticker which starts with ‘Fri’. Stick this along the top of the foil strip where you can see the tablets.

If you’re switching to Elleste Duet from another form of HRT, start taking Elleste Duet once you’ve finished the HRT you’re currently taking. If our prescriber has given you advice on switching from one type of HRT to Elleste Duet, you should follow their instructions. If you’re uncertain, discuss it with our clinician.

You’ll probably experience a monthly bleed, although some women will experience no bleeding at all. This bleed can start anywhere between day 21 of your pack and day five of the next pack. This cycle will normally be the same from month to month.

You may get some irregular bleeding during the first few months of use, but if it persists for longer, send our clinician a message.

What if I miss an Elleste Duet tablet?

Don’t take a double dose to make up for a missed tablet. You may find that you get some breakthrough bleeding or spotting.

How to come off Elleste Duet

You should always speak to our clinician first before you stop taking Elleste Duet. Gradually reducing your dose, rather than coming off Elleste Duet suddenly, is usually recommended, as there’s less chance of your menopausal symptoms returning in the short term.