Elleste Duet Tablets (1mg, 2mg & Conti)

What is Elleste Duet and what is it used for?

Elleste Duet tablets are a combined form of hormone replacement therapy (HRT), used to treat symptoms of menopause. It has two active ingredients, which emulate the two female sex hormones: a natural version of oestrogen (estradiol) and a synthetic version of progestogen (norethisterone).

Cyclical combined treatments like Elleste Duet are appropriate for women who have started suffering from menopausal symptoms but still have somewhat of a menstrual cycle. If you have not had a hysterectomy, you will likely be prescribed a combined treatment.

Elleste Duet is a cyclical treatment – the first 16 tablets in a cycle contain estradiol only, and the final 12 tablets contain a combination of estradiol and norethisterone. This causes a regular period and reduces your risk of cancer.

Three types of Elleste Duet are available. In the 1mg pack, the 16 white tablets contain 1mg estradiol; the 12 green tablets contain 1mg norethisterone as well as 1mg estradiol. In the 2mg pack, the 16 orange tablets contain 2mg estradiol; the 12 grey tablets contain 2mg estradiol and 1mg norethisterone. Elleste Duet Conti tablets contain 2mg estradiol and 1mg norethisterone in all the white tablets.

As your body adjusts to Elleste Duet, you may notice breakthrough bleeding or spotting. Talk to your GP if this continues after more than a few months of treatment. You should review your HRT with your GP at least once each year and have regular gynaecological checkups.

Read our general guide which offers more information on Elleste Duet and bleeding with information on what to expect.

To see how other women have got on using this HRT, read our Elleste Duet reviews page.

HRT will not prevent pregnancy in women who are otherwise fertile. Women under 50 are considered fertile until two years after their final menstrual cycle (for women over 50, this is reduced to one year). Do not use a hormonal contraceptive while undergoing HRT.

What is the menopause?

All women go through the menopause. This usually occurs between the ages of 45 and 55. As you approach this age, your ovaries will produce less and less oestrogen. This has the effect of stopping the menstrual cycle, but the change in hormone levels can lead to several symptoms which may have a substantial impact on day-to-day life.

Physical symptoms include:

• hot flushes (a spontaneous heat that spreads throughout the body, leading to blushing, sweating and an unusually strong heartbeat)
• night sweats
• osteoporosis
• dryness of the eyes or vagina

The hormonal change can also cause distressing psychological effects such as irritability, insomnia and depression.

Experiences with menopausal symptoms vary significantly depending on the individual. They can begin multiple years prior to the menopause itself and remain for many years. Women will, on average, experience symptoms for about four years.

How does HRT work?

Hormone Replacement Therapy eases the symptoms of menopause by supplementing the levels of hormones that the body can produce naturally. Some medicines are oestrogen-only. However, in women who still have a uterus, an uncontrolled increase in oestrogen levels will cause the lining of the uterus (the endometrium) to grow excessively. This will substantially increase your risk of complications such as endometrial cancer. For this reason, some HRT is also combined with synthetic progesterone to lower this risk.

Elleste Duet tablets (1mg, 2mg, & Conti) are a combined HRT containing oestrogen and progesterone and are used in women who are suffering from menopause and have not had a hysterectomy. Women who have had a hysterectomy are more likely to be prescribed Elleste Solo tablets.

Non-medicinal alternatives for the symptoms of menopause

For Night Sweats and Hot Flushes:

• Using A fan
• Cool Showers
• Wearing light clothing

Vaginal Dryness:

• Lubricants

Other Alternatives:

• A healthy diet and regular exercise
• Stopping Smoking

Sources

• Elleste Duet Tablets, Patient Information Leaflet: https://www.medicines.org.uk/emc/files/pil.9510.pdf
• Elleste Duet Conti Tablets, Patient Information Leaflet: https://www.medicines.org.uk/emc/files/pil.9511.pdf
• https://bnf.nice.org.uk/drug/estradiol-with-norethisterone.html
• https://www.nice.org.uk/guidance/ng23/ifp/chapter/About-this-information

How to use Elleste Duet

Elleste Duet HRT follows a 28-day cycle. If possible, begin taking the tablets on the first day of your period. The pill strip will indicate which tablet you are supposed to take next. Once you finish a pack, start a new one the following day.

Elleste Duet should be taken at a similar time each day, according to the directions on the pack. Swallow the tablet whole with a sip of water. This can be done with or without food.

If, for any reason, you forget to take a tablet, take it as soon as possible. However, if it is more than 12 hours late, skip the dose that you missed. Never double your dose to compensate for a dose that you have missed.

Elleste Duet Ingredients

The active ingredients contained in Elleste Duet are: Estradiol (as hemihydrate), norethisterone acetate (combined tablets only)

Elleste Duet tablets also contain the following inactive ingredients to make up the complete product: Lactose monohydrate, maize starch, povidone, talc, magnesium stearate, macrogol 400 and hypromellose (E464).

1mg tablets – indigo carmine (E132), quinolone yellow (E104) and titanium dioxide (E171);
2mg tablets – sunset yellow (E110), titanium dioxide (E171), black iron oxide (E172).

Elleste Duet Conti tablets also contain the following inactive ingredients to make up the complete product: Lactose monohydrate, maize starch, povidone, talc, magnesium stearate, macrogol 400, titanium dioxide (E171), black iron oxide (E172), hypromellose (E464).

Elleste Duet side Effects

Not everyone will experience side effects when they take Elleste Duet, however, if you do they can include:

• nausea
• headache
• breast tenderness
• change in libido
• anxiety
• dizziness
• insomnia
• stomach cramps
• breakthrough bleeding
• diarrhoea
• indigestion
• acne
• skin irritation
• rash
• back pain
• discharge from the vagina
• fluid retention
• weight gain
• womb spasms
• infection

If you are concerned about these effects, or if the product affects you in any other way, stop using it and talk to your doctor or pharmacist.

Find out more information on our dedicated Elleste Duet side effects page.

Elleste Duet Warnings

Reading the following warnings carefully will help to ensure you are selecting an appropriate product.

Elleste Duet is unsuitable for you if you:

• Have ever had breast cancer
• May have cancer which is sensitive to oestrogen (including uterine cancer)
• Have untreated endometrial hyperplasia (an excessively thick womb lining)
• Suffer from a blood clotting disorder, or have ever had a blood clot
• Have recently had a heart attack or stroke
• Have unexplained vaginal bleeding
• Have a history of liver disease
• Suffer from porphyria (a rare hereditary blood disease)
• Are allergic to any of the ingredients in Elleste Duet Conti
• Are pregnant or breastfeeding.

Inform your GP if you plan on taking Elleste Duet and have ever had any of the following health complications:

• Fibroids
• Impaired liver function
• Uterine problems including endometriosis or endometrial hyperplasia
• Circulation problems (e.g. angina, heart attack)
• High risk of blood clots
• Diabetes
• Migraine
• Gallstones
• An autoimmune disorder
• Asthma
• Epilepsy
• Fluid retention
• High blood pressure
• High-fat levels in the blood
• Obesity
• Otosclerosis (a hereditary ear disorder)
• A history of severe allergic reactions
• A family history of breast cancer or another oestrogen-sensitive cancer.

Tell your GP or pharmacist if you have taken or plan to take any of the following medicines:

• Epilepsy medicines (e.g. phenytoin, carbamazepine)
• Tuberculosis medicines (e.g. rifampicin)
• HIV medicines (e.g. nevirapine, ritonavir, nelfinavir)
• Anticoagulants (e.g. warafin)
• St Johns Wort.

As your body adjusts to Elleste Duet, you may notice breakthrough bleeding or spotting. Talk to your GP if this continues after more than a few months of treatment.

HRT may increase your risk of breast cancer. The extent of this risk will vary depending on the length of your HRT treatment and whether you are taking combined or oestrogen-only HRT. Check your breasts regularly for changes to the skin or nipple, or for any noticeable lump. For women who use HRT for more than five years, there may also be a slight increase in the risk of ovarian cancer.

Stop taking Elleste Duet Conti and seek medical attention immediately if you notice early signs of any of the following:

• Blood clots – pain and swelling of the legs, difficulty breathing
• Stroke – sudden migraines, blurred vision
• Heart disease – chest pain that extends to the neck or arm
• Liver disease – yellow colouration of the skin or eyes.

Discuss with your doctor whether your personal benefits of HRT outweigh the risks mentioned above.

Please read all packaging and the Product Information Leaflet before taking any new medicine and inform your doctor of medicines you are taking or intend to take.