Indivina is a combined HRT tablet that has two synthetic hormones in it: medroxyprogesterone acetate and estradiol valerate. These two hormones help to keep your menopausal symptoms in check. Indivina is an effective option for postmenopausal women. Indivina is also a second line treatment for osteoporosis, so postmenopausal women who are at greater risk of brittle bones can benefit from taking it too. Because it’s available as a low-dose combined tablet, it can be an effective option for women who are more sensitive to side effects from oestrogen and progesterone.
How does Indivina work?
When you experience the menopause, your ovaries start to produce less oestrogen, and this reduction in oestrogen in the body triggers menopausal symptoms, including hot flushes, vaginal dryness and discomfort during sex, low mood or anxiety, trouble sleeping, reduced sex drive and night sweats. These symptoms can be uncomfortable for some women, and the synthetic oestrogen in Indivina, estradiol valerate, which makes up for the decline in naturally occurring oestrogen in the body, works to ease them. In isolation though, whilst it helps to tackle symptoms of the menopause, the synthetic oestrogen can cause the womb to keep growing. If left unchecked, this can cause womb cancer (if you still have your womb). This is where the progestin (medroxyprogesterone acetate) comes in; it counters the effects of the oestrogen on the lining of the womb, and reduces your cancer risk. It’s the oestrogen in Indivina that can also prevent osteoporosis. When there’s a decline in the hormone during the menopause, it can cause the bones to become thinner, and more prone to breaking. HRT treatments like Indivina can be a very effective substitute for this loss of natural oestrogen in the body.
Is Indivina the right treatment for me?
If you’re post-menopausal (so if you haven’t had a period for 1 year) and you haven’t had a hysterectomy, continuous combined HRT options like Indivina are usually the recommended treatments. If this doesn't describe where you are in relation to the menopause, it’s likely that you’ll be better suited to a different type of HRT. For example, if you’re getting menopausal symptoms but are still having your period, sequential (or cyclical) HRT products like Elleste Duet tend to be the recommended route. Or if you’ve had your womb removed during a hysterectomy, oestrogen-only HRT products like Elleste Solo and Estradot patches are usually better treatment options. Indivina is a combined HRT product that comes in tablet form. Some women like the simplicity of a tablet, as it’s easy to take. But if you’d prefer a skin patch, combined HRT patches like the Evorel Conti patch are a direct topical alternative to Indivina. Different HRT treatments contain different amounts of hormones, which allows you to get the balance right between an effective treatment and one you can tolerate.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
IndivinaEstradiol/Medroxyprogesterone
How to take Indivina
Take one Indivina tablet each day, at the same time. Calendar days are printed on the blister sheet to help you follow your daily tablet intake.
You can swallow the tablets whole with water.
When you start taking Indivina, you can get some bleeding at times you wouldn’t expect. If this persists beyond a couple of months, or if you get any heavy bleeding, send our clinician a message. They may adjust your dose, or advise you to try a different HRT treatment. You should always take Indivina as instructed by our clinician.
If you aren’t experiencing periods and you haven’t used HRT before, or if you’re switching from another continuous combined HRT treatment, you can start using Indivina on any day.
But if you’re switching from a cyclic HRT course of treatment, start taking Indivina one week after taking the last tablet. You should contact our clinician if you’re uncertain about this.
You’ll usually start on the lowest dose of Indivina for the shortest amount of time that provides you with relief from menopausal symptoms. This can be increased by our clinician if required. If you find that your symptoms haven’t improved after three months, let our clinician know. You should always speak to our clinician first before making any adjustments to your dose.
What if I miss a dose?
If you miss a tablet, leave the tablet you missed in the packet. Then take the next tablet at the normal time. If you miss a dose or use Indivina on an irregular basis, it may trigger some breakthrough bleeding or spotting.
Never take double the dosage to make up for a missed pill as this can cause serious health issues that will need immediate medical attention.
If I want to stop taking Indivina, what should I do?
If you’re looking to stop using Indivina, speak to our clinician first. They can explain the effects of coming off the treatment and explore other options with you, if you’re looking for an alternative.
Any changes to your treatment will need to be monitored to make sure that it's working well for you and not causing unpleasant, persistent side effects.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
IndivinaEstradiol/Medroxyprogesterone
IndivinaEstradiol/Medroxyprogesterone
FAQ: Indivina
Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.
Can Indivina lead to any problems in the body?
Answer:
There is evidence that your risk of breast cancer may increase slightly (by 1%) if you use combined HRT products like Indivina for extended periods.
So to put this increased risk into context, for every 1,000 women from the age of menopause up to 69 years who aren’t using continuous combined HRT treatment, 13 may develop breast cancer. For every 1,000 women in this same bracket who are using continuous combined HRT treatment for five years or more, an additional 10 women may develop breast cancer.
It’s understood that there’s also a slightly increased risk of ovarian cancer amongst women using HRT, but again, it’s very small. For every 1,000 women using HRT for five years, there may be one additional case of ovarian cancer.
HRT tablets (but not patches or gels) like Indivina are linked with a slightly higher risk of developing a blood clot too. Research suggests that HRT in tablet form may lead to nine extra cases of venous thromboembolism for every 10,000 women each year.
What dose of Indivina is best for me?
Answer:
In terms of what’s right for you, it depends on how your body responds to the treatment. You’ll usually start out on the lowest dose (so 1mg estradiol and 2.5mg medroxyprogesterone) to see how effectively this tackles the condition. If you find that your symptoms are not improving on this dose after three months, you should speak to our clinician, who might suggest increasing the dose.
If you find that either the Indivina 1mg/5mg or the Indivina 2mg/5mg doses are too strong, our clinician can adjust these doses for you to something you can tolerate better.
Indivina vs Premique: which is better for me?
Answer:
It all depends on how sensitive you are to progestogen and oestrogen, the hormones in these treatments. Premique, like Indivina, is a continuous combined HRT treatment that’s available as a low dose option, so if you’re more prone to side effects from progestogen and oestrogen, they could be effective products for you.
Both treatments contain the same type of progesterone (medroxyprogesterone acetate) but there is less of it in Premique than there is in Indivina. So if you’re susceptible to side effects from this progestogen, Premique may be the better option for you.
Premique contains conjugated oestrogen, which is a mix of different types of oestrogen, whereas Indivina contains a type of oestrogen called estradiol. This might also inform which is the better treatment for you.
If I want to switch from Indivina to a different treatment, what should I do?
Answer:
With a Treated subscription, you can switch anytime you want to.
Just log into your account and drop our clinician a message. They’ll take onboard any side effects or symptoms you’re experiencing and can recommend alternative HRT treatments that may suit you better.
Your subscription can be adjusted, paused or cancelled at any time.
Why should I buy Indivina online with Treated?
Answer:
We’re making HRT convenient. Let us know about your health, and we’ll recommend HRT treatment options that are safe and suitable for you. You can then choose which medication you like, and how often you’d like to receive it from us (as well as the quantity of treatment). Change, pause or cancel your subscription anytime.
We’re fans of aftercare too. So our clinicians will get in touch with you regularly to find out how you’re getting on with your medication. And if you want to make any adjustments to your treatment, you can. Just send them a message and they’ll get right back to you.
Table 1: Summary of HRT risks and benefits during current use and current use plus post-treatment from age of menopause up to age 69 years, per 1000 women with 5 years or 10 years use of HRT.
Vinogradova, Y., Coupland, C. and Hippisley-Cox, J. (2019).
Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases. BMJ, p.k4810.
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