About oestrogen HRT
|Type of medicine||Oestrogen (may also be spelled estrogen)|
|Used for||Hormone replacement therapy (HRT)|
|Also called||Bedol® (estradiol), Climaval® (estradiol valerate), Elleste-Solo® (estradiol), Estraderm® (estradiol), Estradot® (estradiol), Evorel® (estradiol), FemSeven® (estradiol), Hormonin® (estradiol, estriol, estrone), Oestrogel® (estradiol), Premarin® (conjugated oestrogens), Progynova® (estradiol), Sandrena® (estradiol), Zumenon® (estradiol)|
|Available as||Tablets, patches and gel|
Oestrogen is a female hormone that is used to treat women's health problems including menopausal symptoms. If you have had your uterus (womb) removed by hysterectomy, you may experience the symptoms women often develop during the menopause.
During the menopause or 'change', your female hormone levels begin to fall. Hormone replacement therapy (HRT) replaces these hormones. This helps to relieve some of the problems associated with the menopause, such as hot flushes and vaginal dryness. HRT also protects against osteoporosis, although other treatments are often preferred for this. Most HRT is a combination of two female hormones, an oestrogen and a progestogen. However, if you have had your uterus removed, then it is likely that you only need to take oestrogen HRT therapy.
Different types of natural oestrogen are used in HRT products. These include conjugated oestrogens, estradiol, estriol and estrone. HRT is available as tablets, skin patches or gels. There are several brands for each of these types of HRT. All deliver a set dose of oestrogen into your bloodstream.
If you have not had your uterus removed, it is important that you receive HRT which contains both oestrogen and progestogen. Some of the brands mentioned in this leaflet can be prescribed for women with a uterus, as long as a progestogen is also prescribed for a number of days each month. Please see the separate leaflet called Oestrogen and Progestogen for HRT for more information about this.
Before taking/using oestrogen HRT
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking oestrogen HRT, it is important that your doctor or pharmacist knows:
- If you have migraine-like headaches.
- If you have any unexplained vaginal bleeding.
- If you have had breast cancer or any lumps in your breast, or if a close family member has had breast cancer.
- If you or a close family member ever had a blood clot in the legs or lungs.
- If you have varicose veins.
- If you have diabetes mellitus (too much sugar in your blood).
- If you have liver or kidney problems.
- If you have angina (chest pain) or if you have had a heart attack.
- If you have porphyria (this is a rare inherited blood disorder).
- If you have ever had an allergic reaction to a medicine.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
How to take/use oestrogen HRT
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about the specific brand of oestrogen you have been given, and a full list of possible side-effects from taking it.
- If you have been prescribed tablets: take one tablet every day, at the same time each day. If you forget to take your tablet, read the advice on the manufacturer's leaflet and follow the instructions it gives. You can take the tablets before, during or after your meals.
- If you have been prescribed patches: some patches are applied and left on for a whole week (such as FemSeven® and Progynova® TS), whereas other patches are applied twice a week and removed after 3-4 days. Make sure you are clear how often to use the patches you have been prescribed - the instructions for how to use them will be on the label of the pack. Apply the patches to clean, dry, unbroken areas of your skin preferably below your waist. You should not apply the patches near to your breasts. Each time you use a patch, apply it to a different area so that your skin doesn't become irritated. There are several different strengths of patches, so it is a good idea to check the strength each time you collect a prescription.
- If you have been prescribed gel: the instructions for how much gel to use will be on the label of your pack. Apply the required amount once every day to an area of skin such as your thighs, and allow it to dry for a few minutes before you put on clothes. Do not apply it to or near your breasts. You should wash your hands after applying the gel so you do not pass it on accidentally, but do not wash the area you have applied it to for at least one hour, to give it time to work. If you forget to use the gel but it is still within 12 hours of your usual time, apply it as usual and then carry on as before. If it is more than 12 hours since you should have applied the gel, just wait and apply the next dose when it is due.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. Also, regularly check your breasts for any lumps and go for regular breast screening and cervical smear tests.
- If you are due to have an operation, tell the person carrying out the surgery that you are taking HRT, as you may be advised to stop the treatment for a while if you are likely to be on bed rest.
- If you have diabetes you may need to check your blood glucose more frequently, as oestrogen may affect the levels of sugar in your blood. Your doctor will be able to advise you about this.
- There are some risks which are associated with HRT - your doctor will discuss the benefits and risks of the treatment with you before you start. The risks are reduced when small doses of HRT are used for short periods of time. If used for a long time the incidence of breast cancer and other adverse effects may increase. Because of this, the decision to continue HRT needs to be made individually and your progress should be reviewed at least once a year. If you have any concerns at any time, make an appointment to discuss them with your doctor.
- Travelling that involves long periods of immobility (more than three hours) can increase the risk of serious side-effects and in rare cases may lead to blood clots. Taking appropriate exercise during the journey and possibly wearing elastic hosiery can reduce this risk. If you would like more advice about this, speak with your doctor or pharmacist.
- Before buying any medicines, check with your pharmacist which medicines are safe for you to take alongside oestrogen HRT.
- HRT treatments are not suitable for preventing pregnancy.
Can oestrogen HRT cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
|Possible oestrogen HRT side-effects||What can I do if I experience this?|
|Feeling or being sick||Eat simple meals (avoid rich or spicy foods)|
|Headache||Ask your pharmacist to recommend a suitable painkiller. If the headache continues or is unusually severe, speak to your doctor as soon as possible|
|Feeling dizzy||Getting up or moving more slowly should help|
|Dry eyes||If you wear contact lenses, ask your optician for advice if this becomes troublesome|
|Stomach cramps, bloating, weight changes, breast tenderness, fluid retention, rash, changes in sexual desire, mood changes, leg cramps. Patches can also cause skin irritation||Speak with your doctor if any of these become troublesome|
Stop taking this medicine and contact your doctor for advice straightaway if you develop any of the following symptoms:
- Sudden chest pain.
- Sudden breathlessness, or if you cough up blood.
- Swelling or pain in a leg.
- An unusually severe headache.
- Jaundice (yellowing of your skin or the whites of your eyes).
If you experience any other symptoms which you think may be due to this medicine, discuss them with your doctor or pharmacist.
How to store oestrogen HRT
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Further reading & references
- British National Formulary; 63rd Edition (Mar 2012) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Helen Huins