Combined HRT (oestrogen + progestogen)

Estradiol with dydrogesterone

Brand names: Femoston

Adult dose

Dose: 1 tablet OD per pack regimen (sequential or continuous)

Route: Oral

Frequency: OD

Clinical pearls

Sequential preparation for women still having periods (perimenopausal); continuous combined for ≥1 year amenorrhoea or >54 years
Dydrogesterone progestogen: lower VTE signal in observational data vs other progestogens (BMS)

Contraindications

Same as oestrogen + progestogen HRT — see estradiol
Undiagnosed vaginal bleeding
Active VTE / arterial events
Severe liver disease

Side effects

Breakthrough bleeding
Breast tenderness
Headache
Mood changes
VTE
Breast cancer risk

Interactions

CYP3A4 inducers
Lamotrigine

Monitoring

BP
Bleeding diary
Breast awareness

Reference: BNF; NICE NG23; British Menopause Society; https://bnf.nice.org.uk/drugs/estradiol-with-dydrogesterone/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

FAST Exam Protocol — Focused Assessment with Sonography in Trauma · Trauma

Drugs

Pathways