Estradiol/norethisterone

Elleste Duet®

Elleste Duet

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Estradiol/norethisterone

Elleste Duet ®

Elleste Duet is a combined HRT tablet that relieves menopausal symptoms. It’s a second line treatment for osteoporosis too. 

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From only £6.66 per month

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Elleste Duet is a HRT tablet that has two hormones in it: a type of progesterone and a type of oestrogen, which help to ease symptoms of the menopause. Or if you like to limbo with the lingo, it’s a combined sequential oral treatment.

If you’re more susceptible to bone fractures and osteoporosis (as some women are after the menopause) Elleste Duet can be a suitable preventative treatment for this too.

At EveAdam, we’re all about convenience. With a subscription, you have a consultation with one of our licensed prescribers, and choose your HRT. Once you’ve settled on your treatment, our clinician will see to your prescription, and our pharmacy will see that it’s dispensed. You can set your own delivery schedule, and we’ll make sure that it arrives at your door when you want it to.

Finito.

What is 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 a form of synthetic oestrogen called estradiol hemihydrate and a type of synthetic progesterone known as norethisterone acetate.

They’re not really terms that stick in the mind easily, and you’d probably think twice about them as band names, but they both have important roles in the body. 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.

How does Elleste Duet work?

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 though, 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 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.

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 your clinician.

Page reviewed by:
Mr Craig Marsh
Mr Craig Marsh
Pharmacist Prescriber
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Last updated 01/07/2021

What you need to know about Elleste Duet

Is Elleste Duet the right HRT for me?

If you’re getting menopausal symptoms and are continuing to have periods, combined sequential HRT options such as Elleste Duet and Evorel Sequi patches tend to be the recommended treatments. Like other forms of HRT however, 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 products are best for you as part of your EveAdam consultation.

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 1 year. You take continuous combined HRT every day, without a break in between.

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.

Elleste Duet: availability over the counter

Where can I get Elleste Duet online?

How to take Elleste Duet

Take Elleste Duet as instructed by your prescriber. Your clinician will look to prescribe you with the lowest dose possible to treat your symptoms for as short a period of time as they can.

If you think that the dose you have been prescribed is either not strong enough or too strong, you should let your clinician know. They may decide to adjust your dose, or can discuss alternative treatment options with you where necessary.

If you are still experiencing 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 1 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. 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 consists of 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 are switching to Elleste Duet from another form of HRT, start taking Elleste Duet once you’ve finished the HRT you’re currently taking. If your 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 your clinician.

You will probably experience a monthly bleed (although some women may not have any). This bleed can start anywhere between day 21 of your pack and day 5 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 beyond this timeframe, let your prescriber know.

What if I miss an Elleste Duet tablet?

How to come off Elleste Duet

Can I delay my period on Elleste Duet?

Can Elleste Duet give you headaches?

Yes. Headaches are a very common side effect with Elleste Duet, affecting more than 1 in 10 women. They usually subside within a few weeks of taking HRT, but if you find that your headaches persist, you should let your prescriber know. They may recommend alternative HRT products if necessary.

What are the most common Elleste Duet side effects?

When should I see a doctor?

Can Elleste Duet cause weight loss?

If I can’t take Elleste Duet, what are the alternatives?

Our clinician can talk you through any other alternative treatment options during your EveAdam consultation.

Making certain adjustments to your lifestyle can sometimes help to ease menopausal symptoms:

  • Sticking to a balanced diet can help you to maintain a healthy weight, and keep your bones healthy
  • Regular exercise can reduce hot flushes, and improve sleep too. It can also boost your mood if you’re feeling irritable, depressed or anxious. Any weight-bearing activities are particularly beneficial for keeping your bones strong
  • Wearing loose-fitting clothes at night and sleeping in a room that’s well-ventilated can help if you experience any night sweats or hot flushes
  • Cutting back on caffeine, alcohol and spicy food can help with hot flushes
  • Vaginal lubricant or moisturiser may be effective treatments for vaginal dryness

Is Kliofem the same as Elleste Duet?

Novofem and Elleste Duet: are they the same?

Elleste Duet SAFETY INFO

Before using Elleste Duet, you should always read the patient information leaflet that comes with your tablet. 

If anything is unclear to you, just drop our prescriber a message using your EveAdam account. They should be able to answer any questions you have. 

More on using HRT treatments safely here.

Can Elleste Duet interact with other medications?

Yes. It can interfere with other treatments, which may impact on its effectiveness in the body, and trigger irregular bleeding.

It’s important then that you let our prescriber know about any medications you’ve recently taken, or are currently taking, during your EveAdam consultation.

You can read more about combined HRT products and interactions here.

Can all women use Elleste Duet?

References

[1] Newson, Louise R. 2016. Best practice for HRT: unpicking the evidence. British Journal of General Practice. NCBI. [online]. 2016 Dec; 66(653): 597–598. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198659/ [Accessed March 22nd 2021].

[2] Fait, Tomas. 2019. Menopause hormone therapy: latest developments and clinical practice. Drugs in Context. NCBI. [online]. 2019; 8: 212551. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6317580/ [Accessed 10 February 2021].