Oestrogen tablets for menopausal hormone therapy

Key points about oestrogen tablets

  • Oestrogen tablets are used for menopausal hormone therapy (MHT).
  • Examples of oestrogen tablets include Premarin, Ovestin, Estrofem, Progynova.
  • Find out how to take it safely and possible side effects.
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Oestrogen tablets are used as menopausal hormone therapy (MHT) to replace oestrogen. Your ovaries are no longer making oestrogen during perimenopause and after menopause. Using MHT can help to relieve some of the symptoms of menopause and can make a big difference to the enjoyment of life for some people. Read more about menopausal hormone therapy (MHT).

If you haven't had a hysterectomy (operation to remove the uterus), you must take another type of hormone called a progestogen as well as using the oestrogen tablets. A progestogen helps to protect the lining of the uterus. If you haven't been asked to take a progestogen with your oestrogen, talk to your doctor.  

Note: Oestrogen is also available as skin patches or vaginal cream or pessaries. The information on this page is only about oestrogen tablets. Read more about oestrogen vaginal cream or pessaries or oestrogen patches.  

In Aotearoa New Zealand tablets are available as different products and in different strengths. Examples of oestrogen tablets include Premarin, Ovestin, Estrofem, Progynova. 

The strength of tablet will depend on the severity of your symptoms. Your healthcare provider will advise you on the best dose for you.

Benefits

  • Oestrogen reduces the severity and frequency of hot flushes by around 85%.
  • Oestrogen improves vaginal dryness.
  • By reducing menopausal symptoms, oestrogen may improve sleep and quality of life.
  • Oestrogen reduces the risk of post-menopausal bone fracture, including hip fracture.

Note: Women who go through menopause before 45 years are advised to take oestrogen until the age of average menopause at 50 years. The decision to continue oestrogen beyond 50 should be reviewed every year in consultation with your doctor.

Risks

The risks associated with taking oestrogen are not the same for everyone. Your healthcare provider will be able to discuss your individual risk in more detail.

  • Blood clots
    • Oestrogen tablets may increase the risk of blood clots, but overall it's still very low (1 extra blood clot per 1000 women).
  • Stroke
    • There's no increased risk of stroke if you don’t already have risk factors for stroke and you're in your 50s or during the first 10 years of menopause. If you have risk factors you can probably still safely use a patch.
  • Gallbladder problems
    • Oestrogen tablets are associated with an increased risk of gallbladder inflammation (cholecystitis). There are no data regarding the use of skin patches.
  • Breast cancer
    • Overall 1 in 8 women will develop breast cancer during their lifetime. Studies suggest there's either no increase, or a very small increased risk of breast cancer when using oestrogen only MHT. Breast cancer risk is lower with oestrogen only MHT compared with oestrogen plus progestogen.
  • Heart disease
    • Oestrogen may decrease the risk of heart disease if started within 10 years of menopause or before the age of 60.

Every person is different and the length of time you will have menopausal symptoms is unknown.

People who go through menopause before 45 years are advised to take oestrogen therapy until the average age of menopause – around the age of 50 years.

It’s important to have regular check-ups with your doctor to assess whether ongoing oestrogen is right for you. Most people stop taking it after a few years, when their symptoms resolve. It's usually best to reduce menopausal hormone therapy gradually rather than stopping it suddenly. This may reduce the risk of menopause symptoms returning.

The following links have more information on MHT. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.
Menopause(external link) Sexual Wellbeing Aotearoa
Menopause health information(external link) Australasian Menopause Society
Menopause and HRT(external link)  Patient Info, UK

Resources

Menopausal Hormone Therapy (MHT) factsheet – what is it and is it safe?(external link) Australasian Menopause Society, Australia
Menopausal Hormone Therapy (MHT) infographic – what is it and is it safe?(external link) Australasia Menopause Society, Australia

References

  1. Oestrogen only menopausal hormone therapy(external link) Australasian Menopause Society

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

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