Femoston HRT tablets

Femoston is a type of HRT that is for anyone who is menopausal and still has a womb. It is an oral tablet that you swallow every day and helps relieve symptoms, such as night sweats and hot flushes, and protects against osteoporosis caused by the natural decline in oestrogen.

Each Femoston pill contains artificial versions of the hormones oestrogen (oestradiol hemihydrate) and progesterone (dydrogesterone) to bring hormones back into a normal range.

Femoston is available in 2 different courses:

• Sequential
• Continuous

Sequential – This type mimics a woman’s natural cycle and involves taking different tablets at different times during a 28-day cycle. It is available in 2 doses: Femoston 1/10 and Femoston 2/10. This is for anyone who is menopausal and has not had their womb removed.

Continuous – You’ll take a tablet containing both oestrogen and progesterone every day without a break. Femoston Conti is available in 2 doses – 0.5mg/2.5mg and 1mg/5mg. Femoston Conti is for anyone who is postmenopausal, whose last period occurred at least 12 months ago, and still has a womb.

The active ingredients in Femoston, oestradiol hemihydrate and dydrogesterone, work to replace the hormones that decrease during menopause. Oestradiol is a type of oestrogen that helps relieve symptoms such as hot flushes, night sweats, and vaginal dryness, while dydrogesterone (progesterone) protects the womb lining.

When you take oestrogen, it causes the womb lining to thicken. In people who still have their womb intact, this can increase the chance of endometrial cancer, so the addition of dydrogesterone reduces this risk.

How long does Femoston last?

Each Femoston tablet lasts a day, so you need to take it once a day to keep the effects up. Femoston comes in 28-day strips, so one strip will last 28 days. Since they contain 3 strips each, a pack lasts around 3 months.

How long does Femoston take to work?

Femoston is a type of sequential HRT which can take up to 3 months to work to fully improve your symptoms. If your symptoms have not improved by then, you should get in touch with a doctor who can suggest alternatives.

How effective is Femoston?

Clinical trials have shown that Femoston can relieve menopause symptoms within the first few weeks of treatment. Regular withdrawal bleeding occurred in up to 80% of people on the Femoston 1/10 dose and 90% on the higher Femoston 2/10 dose.

The reduction in oestrogen during menopause can increase the chance of osteoporosis. After 2 years on the Femoston 1/10 dose, 67 to 78% of people gained bone mineral density (BMD) in 3 areas of the hip; this increased to 71 to 88% in the higher-dose group.

Femoston is a sequential HRT, so you’ll take tablets containing oestrogen only for 14 days, followed by a pill containing oestrogen and progesterone for the remaining 14 days. You should swallow each tablet whole with water, with or without food.

To take Femoston:

1. On days 1 to 14, take 1 tablet daily containing 1 or 2mg of oestradiol. These tablets are marked with ‘arrow 1’.
2. On days 15 to 28, take 1 tablet daily containing 1 or 2mg of oestradiol and 10mg dydrogesterone. These are marked ‘arrow 2’.
3. When you finish the current strip, start a new strip the next day. You do not have a break.

It is best to take Femoston pills at the same time every day to keep your hormones balanced and to help you remember to take them. Choose a time that is convenient for you.

How long do you need to take Femoston for?

Most people take HRT for 2 to 5 years to treat their menopause symptoms, but some people may need to take it for longer. Your doctor will discuss how long you may need to take Femoston, as well as its benefits and risks.

What if I miss a dose of Femoston?

If you forget to take Femoston and it has been less than 12 hours, take the missed pill as soon as you remember.

If it has been more than 12 hours since your last dose, take the next dose as usual, but skip the forgotten pill. Do not take a double dose to make up for a missed dose. You may get some bleeding or spotting if you miss a Femoston dose.

What if I take too much Femoston?

If you take too much Femoston, it is unlikely to cause you harm, but you may feel or be sick, have breast tenderness, dizziness, stomach pain, drowsiness, or withdrawal bleeding. You should not need treatment, but if you are concerned, speak to your doctor for advice.

Femoston, as a sequential HRT, is available in 2 doses:

• Femoston 1/10 – This contains 1mg of oestradiol and 10mg of dydrogesterone.
• Femoston 2/10 – This contains a higher 2mg of oestradiol, and 10mg of dydrogesterone.

You’ll usually start on the lower 1mg/10mg dose, but your doctor may increase your dose to Femoston 2/10 if your symptoms are not improving on the lower dose and your body is responding well to the treatment.

Femoston is a prescription-only HRT treatment, so you will need a doctor’s approval to get it. You may be able to get it online from trusted online services, or you may be able to get it on the NHS following a consultation with your GP.

Can I buy Femoston online?

Yes, you can request Femoston from ZAVA. To order Femoston from us, you’ll need to:

1. Complete a short online health questionnaire for one of our doctors to review.
2. Log in to your account or create one and provide payment information.
3. Once approved, your treatment will be sent by Royal Mail to your home address, or you can choose to collect it from your local Post Office.

Ordering HRT from ZAVA is a quick, convenient service that lets you avoid waiting for an appointment; you can fit it around your busy schedule.

Can I buy Femoston over the counter?

No, Femoston is a prescription-only treatment, which means you cannot buy it over the counter.

Can I get Femoston on the NHS?

Yes, Femoston may be available on the NHS, but you will need to make an appointment with your GP to find out if it is suitable for you and available in your area.

Like all medications, Femoston may cause side effects, but not everyone will get them.

Very common side effects (affecting more than 1 in 10 people) are:

• headache
• abdominal pain
• back pain
• breast tenderness or pain

Common side effects (affecting less than 1 in 10 people) are:

• vaginal thrush
• depression
• nervousness
• migraine
• feeling or being sick
• dizziness
• wind
• allergic skin reaction
• bleeding between periods or spotting, heavy, regular, or painful periods
• pelvic pain
• vaginal discharge
• feeling generally unwell, weak, or tired
• swollen ankles, feet, or fingers
• weight gain

Uncommon side effects (affecting less than 1 in 100 people) are:

• cystitis symptoms
• changes in sex drive
• fibroid growth
• high blood pressure
• peripheral vascular disease
• varicose veins
• blood clots in the veins of the legs or lungs
• indigestion
• liver disorders
• gall bladder disorder
• swollen breasts
• pre-menstrual tension (PMT)
• weight loss

Rare side effects (affecting less than 1 in 1000 people) are:

• heart attack
• swelling of the face and neck
• red or brown patches on the skin

This is not a full list of potential side effects. A complete list can be found in the Femoston patient information leaflet that comes with the medication.

How long do Femoston side effects last?

Femoston side effects usually last for a few weeks to up to 3 months as your body adjusts to the active ingredients. Common side effects like headaches and breast tenderness should improve after 4 to 6 weeks, while irregular bleeding can take 3 to 6 months to get better.

What to do if you get Femoston side effects

Most mild Femoston side effects can be managed at home by:

• getting some rest until you feel better
• taking over the counter painkillers, like paracetamol and ibuprofen, for headaches and stomach pain
• staying hydrated
• eating smaller, more frequent meals if you feel sick
• getting some gentle exercise

If your symptoms do not improve or you are finding them difficult to manage, speak to your doctor for more advice.

If you get any of the following serious side effects while taking Femoston, stop taking it and contact your doctor straight away, or in an emergency call 999:

• allergic reactions, which may cause swelling around the face and neck and difficulty breathing or swallowing
• heart attack
• tumours that may be affected by progesterone levels
• heavy, irregular, or painful genital bleeding

Does Femoston cause weight gain?

Weight gain is listed as a potential side effect of Femoston, but there is no good scientific evidence to suggest that sequential HRT causes you to put on weight long term. It is common for some people to gain weight during the menopause, but lifestyle factors like eating a balanced diet and exercising regularly can help.

Some research suggests that Femoston 2/10 can help prevent increases in body fat mass.

Femoston may not be suitable for everyone.

Do not take Femoston if you:

• have or have ever been diagnosed with meningioma
• have or have ever had breast cancer
• have oestrogen-sensitive cancer
• have a tumour that is sensitive to progesterone
• have any unexplained vaginal bleeding
• have excessive thickening of the womb lining
• have or have ever had a blood clot in a vein
• have a blood clotting disorder
• have or have recently had a disease caused by blood clots in the arteries, such as a heart attack, stroke, or angina
• have or have ever had liver disease and your liver function tests have not come back as normal
• have a rare blood problem called porphyria
• are allergic to oestradiol, dydrogesterone, or any other Femoston ingredients

Tell your doctor before taking Femoston if you have ever had any of the following:

• fibroids in the womb
• endometriosis
• increased risk of blood clots
• increased risk of oestrogen-sensitive cancer
• high blood pressure
• a liver disorder
• diabetes
• gallstones
• migraine or severe headaches
• immune system disease
• epilepsy
• asthma
• otosclerosis
• very high blood fat levels
• fluid retention caused by heart or kidney problems
• hereditary or acquired angioedema

Femoston and other medications

Before taking Femoston, tell your doctor if you are taking any prescribed, over-the-counter, or herbal medications. Some medications can interfere with the effectiveness of Femoston, causing irregular bleeding, such as:

• epilepsy medications
• tuberculosis medications
• medications for HIV
• herbal remedies containing St John’s Wort

HRT can affect how the following medications work:

• lamotrigine for epilepsy
• Hepatitis C medications

If you take any of the following, your doctor may need to monitor your response and adjust the dose:

• tacrolimus and cyclosporin
• fentanyl
• theophylline

If you have not had a period for at least 12 months and you have not had your womb surgically removed, you will need continuous HRT. At ZAVA, we can provide the following continuous HRT methods:

• Elleste Duet Conti
• Evorel Conti
• Kliofem
• Kliovance
• Femoston Conti

Other types of HRT

If you are getting symptoms such as vaginal dryness or irritation, vaginal creams, including estriol cream or Ovestin, can help. These are applied directly inside the vagina to help target the source of the issue.

If you’re not sure if you have reached menopause, our menopause test kit can give you an accurate diagnosis.

What is the difference between Femoston and Femoston-Conti?

Femston and Femoston Conti are both types of HRT that contain the active ingredients oestradiol and dydrogesterone, but they are taken differently and intended for different menopause stages. Femoston is a sequential HRT which is for anyone who is in perimenopause and still has a womb. It involves taking oestrogen daily and a combination of oestrogen and progesterone for 14 days of a 28-day cycle. When this cycle ends, you’ll have a withdrawal bleed, similar to a period.

Femoston Conti is a continuous HRT which is for anyone who is postmenopausal or has not had a period for at least 12 months. It is taken daily and usually causes no bleeding.