Kliovance

Because it’s a combined HRT, which means there are two types of hormones in it, Kliovance is for women with an ‘intact uterus’ (which is a clinical way of saying ‘haven’t had a hysterectomy’).

Kliovance is very similar to another type of HRT pill called Kliofem. The main difference is the dose: Kliovance is basically half the dose of Kliofem, so is better for women who have a higher than usual sensitivity to hormones.

There are two hormones in Kliovance: estradiol and norethisterone. These are an oestrogen and progestogen, and taking Kliovance basically helps to top up your hormone levels as they fall during the menopause.

More specifically, it’s falling oestrogen levels that need replacing when you go through the menopause. When your oestrogen levels naturally drop, this is when you get symptoms like hot flush and mood swings, and your bones can become progressively weaker.

The reason progesterone is given as well is because it helps to balance out the effects of oestrogen in the body. If there’s too much ‘unopposed’ oestrogen in your system, your risk of problems in your womb lining, including cancer, increases. So it’s included in combined HRT as a way of keeping oestrogen in check.

In women taking both estradiol and norethisterone acetate against estradiol alone, the risk of the womb lining becoming unusually thick (endometrial hyperplasia) was much lower in comparative studies. ^[1]

You can take Kliovance if you’ve not had a hysterectomy, and you’ve not had a natural period for at least a year. It’s a combined continuous HRT, which is what you’ll take if you’re ‘postmenopausal’. If you’re ‘perimenopausal’ (so if you had your last menstrual period less than a year ago’) you’ll normally be recommended sequential HRT instead. In sequential HRT, the hormones delivered in the pill change throughout the month. In continuous HRT, they stay the same.

Kliovance might also be helpful for you if you’ve tried HRT pills with a slightly higher dose and had side effects, because it’s a lighter dose.

Basically, Kliovance is a lower dose version of Kliofem. So if you’ve taken Kliofem and it generally worked well for you, but you had mild side effects, switching to Kliovance may help you get the right balance.

The instructions for Kliovance are:

• Take one pill a day, at the same time every day without a break
• There are 28 in each pack, and they come in a calendar pack so you can keep track of the pills you’ve taken easily
• Swallow whole with water
• If you miss a pill but remember inside 12 hours of your normal pill time, take the one you missed and take the next one at the normal time
• If you miss a pill but remember after 12 hours of your normal pill time, skip the one you missed and take the next one at the normal time
• You can start Kliovance whenever you like, but if you’re switching from another HRT where you have a withdrawal bleed, it’s best to start it right after the bleeding has stopped.

Make sure you read the leaflet before you take Kliovance. If there’s anything you aren’t sure of, let us know.

Hormone replacement therapy lasts for between two and five years for most women. It’s likely you won’t stay on the same treatment the whole time. You might start on a sequential treatment, move onto a continuous treatment, and then it’s common to ‘taper’ your dose (reduce it slowly) before stopping.

So how long you take Kliovance for can vary. Because Kliovance is a lower dose continuous HRT pill, it’s more likely you’ll take it towards the end of your term using HRT. You’ll normally have your symptoms monitored for a while before coming off HRT completely.

When you stop using hormone replacement therapy, it’s normal to have some amount of ‘relapse’ where you get some menopause symptoms, but these usually don’t last very long. If they continue for a few months, it’s best to speak to a doctor.