Estradot 50 Patches / Utrogestan Capsules

If you have had a period in the last 12 months, you should use sequential HRT. This is where you only take Utrogestan for part of the month. You should take 200mg Utrogestan (2 capsules) once a day before bed for 12 days. You should take them for the same 12 day period each month. After taking the Utrogestan capsules you will have a few days of withdrawal bleeding, like a period.

If you have not had a period in the last 12 months, or you have already been using sequential HRT for 12 months, you can use continuous HRT. You should take 100mg Utrogestan (1 capsule) every day.

If you forget a capsule, take it as soon as you remember. If it is almost time for your next dose, wait until your next dose instead. Do not take a double dose, even if you missed a dose.

Estradot 50 patches are a patch that is applied to the skin. To apply your patch, take it from the protective pouch and remove the backing. Apply the patch to a clean, dry area of your lower abdomen (below the belly button) and hold for 10 seconds. The patches can get wet and should not fall off. If it does, wait until the patch is dry and reapply the same patch to another area of the lower abdomen.

The patches should be replaced twice a week, every 3 to 4 days. Replace the patch on the same day each week, such as every Monday and Thursday. Estradot 50 patches contain a calendar on the back, to help you remember. The patch should be worn all the time, until it is time to change it. Use the patches on a different area of the skin each time, to reduce irritation.

If you forget to change the patch, change it as soon as you remember. Follow your usual schedule, even if you have used a new patch on a different day than normal. Do not use 2 patches at once to make up for a missed dose.

The main form of treatment for menopause symptoms is HRT medication. There are other forms of HRT medication if you cannot take a capsule or do not want to use a patch. You can also find combined treatments, rather than taking 2 separate treatments.

Other forms of HRT medications include:

• vaginal rings
• vaginal creams and gels, like Ovestin and Estriol
• vaginal pessaries, like Vagifem
• tablets, which can contain either oestrogen or progesterone, or a combined treatment which contains both, such as Elleste duet conti tablets

We offer many of these treatments, so if you are unsure which treatment is best for you, speak to one of our doctors. Alternative treatments, such as herbal remedies, are not recommended to relieve symptoms of menopause, as there is not enough evidence to show how effective or safe they are.

There are some lifestyle changes that can help if you have menopausal symptoms, which can be used alongside HRT medication, such as:

• exercising and eating a balanced diet to lose weight if you are overweight
• taking supplements like vitamin D, especially if you are at risk of osteoporosis
• avoiding any triggers which can cause hot flushes, such as alcohol, smoking, and caffeine
• wearing light clothing if you have hot flushes often
• using a natural method to cool down during a hot flush, like a cold drink or shower
• minimising stress levels through yoga or other relaxing practices, especially if you get mood swings

There are some side effects with both HRT medications, but these usually go away once you get used to the treatment. If they do not, or the side effects become severe, speak to your doctor.

Estradot 50 patches

Very common side effects include:

• skin irritation at the patch application site
• breast pain
• menstrual pain
• headache

Common side effects include:

• mood changes
• trouble sleeping
• nausea (feeling sick)
• depression
• acne
• irregular vaginal bleeding
• weakness

Uncommon side effects include:

• dizziness
• increased blood pressure
• a change in liver function
• skin discolouration
• vomiting (being sick)

Rare side effects include:

• blood clots
• small growths in the womb, known as polyps
• allergic reactions
• numbness or tingling in the hands and feet
• gallstone
• changes in sexual desire

Very rare side effects include:

• severe allergic reaction
• excessive hair growth
• hives
• involuntary movements which can affect the head and neck

If you get a serious allergic reaction, you must visit A&E or call 999 straight away. When taking Estradot 50 patches, you should visit your doctor regularly, who will check for any side effects. Speak to them if you notice any changes to your body since starting HRT medication. This is not a full list of side effects. For a full list, see the patient information leaflet.

There are some medications that can interact with Estradot 50 patches and could cause irregular bleeding, so speak to your doctor if you also take:

• anti-infective medicines, such as erythromycin
• medication for epilepsy, such as phenytoin
• medication for HIV, suit as ritonavir
• medication for tuberculosis, such as rifabutin
• herbal remedies that contain St John’s wort

If you take any other medicines or are not sure, speak with your doctor to make sure it is safe to take Estradot 50 patches.

Utrogestan capsules

Utrogestan capsules are a newer form of HRT medication. This means there has not been enough time to show whether some of the side effects are common, uncommon, or rare.

Whilst taking Utrogestan capsules, some women may get:

• vaginal bleeding
• stomach pain
• nausea (feeling sick)
• headache
• dizziness
• itchy skin
• drowsiness

During the clinical trials for Utrogestan, some side effects included:

• depression
• hot flushes
• vaginal discharge
• bloating
• tender breasts
• joint pain
• urinary problems

How often these side effects can happen is not yet known but like other HRT medication, most side effects should go away on their own. If they are severe, speak to your doctor. For more information on side effects, see the patient information leaflet.

The capsules contain soybean lecithin, meaning they may not be suitable if you have an allergy to soy products. There are some medicines that can affect the way Utrogestan works in your body. This could cause irregular bleeding.

Speak to your doctor first if you take:

• tizanidine, a medication for multiple sclerosis
• fungal infection medication
• water tablets, such as spironolactone
• medication for epilepsy, such as phenobarbital
• bromocriptine, used for Parkinson’s disease
• medication for tuberculosis, such as rifampicin
• ciclosporin, used for the immune system
• medication for HIV, such as nelfinavir
• herbal remedies that contain St John’s Wort
• antibiotics
• any medication for diabetes
• any medication for blood clots
• emergency contraceptives
• diazepam

Contraindications

You must not take any HRT medication if you:

• are allergic to progesterone or oestrogen
• have, or have ever had, a blood clot
• have, or have ever had, breast cancer
• have, or have ever had, any cancer which is sensitive to oestrogen, such as cancer of the womb lining
• are pregnant or breastfeeding
• have a blood clotting disorder
• have, or have ever had, liver disease
• have a rare blood condition, known as porphyria