Medroxyprogesterone/estradiol

Indivina®

Indivina

From only £9.99 per month

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Medroxyprogesterone/estradiol

Indivina ®

Indivina is a combined HRT tablet that treats menopause symptoms. It can also be used to help prevent osteoporosis. 

You can buy Indivina online with an EveAdam subscription, and get it delivered to your door on a regular basis from a UK pharmacy. 

From only £9.99 per month

Discreet delivery to your door when you buy Indivina online with EveAdam.

Indivina is a continuous combined HRT tablet, or to put it more simply, it’s a tablet with two hormones in it that help to ease symptoms of the menopause. It can also help to prevent osteoporosis, which is more common after the menopause. It’s a tablet that’s suitable for menopausal women who have not had a period for at least 3 years.

At EveAdam, it’s super easy to set up an online subscription for Indivina. Following a consultation with our prescriber, you can choose the best HRT treatment for you. It’s then just a case of selecting how often you’d like to receive your tablet, and the amount of tablets you’d like us to deliver to you each time. Our clinician will put together a prescription for you, and our pharmacy will do the rest.

If it’s approved before 4pm, your first package will be delivered to you by secure courier the next working day. And after that, we’ll work to whichever delivery schedule you’ve decided on.

What is Indivina?

Indivina is a combined HRT tablet that contains two synthetic hormones: medroxyprogesterone acetate and estradiol valerate. The former sounds science-y beyond belief – enough to make the periodic table weep – but it’s just a progestin that imitates the naturally occurring hormone progesterone in the body.

Estradiol valerate is a type of oestrogen that imitates natural oestrogen in the body. Between them, the two hormones help to keep your menopausal symptoms in check, and compared with taking oestrogen in isolation, they reduce your risk of developing endometrial cancer.

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, and left unchecked, this can cause endometrial cancer (if your womb is still intact). 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.

Still awake? Brilliant. Basically, the two hormones have slightly different roles in the body, but together, they’re an uber dynamic duo.

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 susceptible to breaking. HRT treatments like Indivina can be a very effective substitute for this loss of natural oestrogen in the body.

What dose of Indivina is best for me?

It all depends on how your body responds to it. You will usually start out on the lowest dose (so 1mg estradiol and 2.5mg medroxyprogesterone) to see how effectively this tackles your symptoms. If you find that your symptoms are not improving on this dose after three months, you should speak to your clinician, who may increase the dose.

If you find that either the Indivina 1mg/5mg or the Indivina 2mg/5mg doses are too strong, your prescriber can adjust these doses for you too.

Page reviewed by:
Mr Craig Marsh
Mr Craig Marsh
Pharmacist Prescriber
Visit author profile
Last updated 30/04/2021

What you need to know about Indivina

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. But if your circumstances are different, it’s likely that you’ll be better suited to a different type of HRT treatment.

For example, if you’re experiencing 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 have had your womb removed during a hysterectomy, oestrogen-only HRT products such as Elleste Solo and Estradot patches are usually better treatment options for you.

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. You replace the patches every couple of days.

Different HRT treatments contain different amounts of hormones, so if a particular quantity of hormones give you adverse side effects, this can play a role in which HRT products are more suitable for you too.

Can you get Indivina over the counter?

How to get Indivina online

How to take Indivina

When you start taking Indivina, you can experience some bleeding at odd times for a few months. If this persists beyond a couple of months, or if you get any heavy bleeding, let your prescriber know. 

You should always take Indivina as instructed by your 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 of the cyclic HRT. You should contact your prescriber if you’re uncertain about this.  

You will 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 your clinician if required. 

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. 

If necessary, swallow the tablets whole with water.

If you find that your symptoms haven’t improved after three months, you should discuss this with your prescriber. You should always speak to your clinician first before making any adjustments to your dose. 

What if I miss a dose?

If I want to stop taking Indivina, what should I do?

What are the most common Indivina side effects?

Common side effects with Indivina are: headache, feeling dizzy, hot flushes, sweating more, feeling sick, vomiting, stomach cramps, flatulence, pain and tension in the breasts, vaginal discharge, bleeding or spotting, menstrual disorder and disorder of the vulva / vagina.

If I get side effects, what should I do?

When should I see a doctor?

Can Indivina lead to any problems in the body?

Does Indivina cause weight gain?

Indivina vs Premique: which is better for me?

It all depends on how sensitive you are to progestogen and oestrogen, really. 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. Again - it’s very much a case of which of these hormones cause you fewer side effects, in terms of which of the two products is best for you.

If I want to switch from Indivina to a different treatment, what should I do?

What should I do if Indivina doesn’t work?

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

Indivina SAFETY INFO

Before taking Indivina, you should always read the patient information leaflet that comes with your treatment.

More on using HRT treatments safely here.

Can Indivina interact with other medications?

Indivina can interact with other forms of medication, which may cause irregular bleeding. Some treatments can impact on its effectiveness.

If you’ve recently used, or are currently using, other forms of medication, let our clinician know during your consultation.

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

Is Indivina suitable for all women?

References

[1] MHRA. 2019. 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. Available at: https://assets.publishing.service.gov.uk/media/5d680409e5274a1711fbe65a/Table1.pdf [Accessed 27 Jan. 2021].

[2] Baber, R. 2015. Menopausal hormone therapy and ovarian cancer. J Midlife Health. [online]. pp. 101-103. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604667/ [Accessed 27 Jan. 2021].

[3] Vinogradova, Y. Coupland, C. 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. [online]. 2019;364:k4810. Available at: https://www.bmj.com/content/364/bmj.k4810 [Accessed 27 Jan. 2021].