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Combined HRT (oestrogen + progestogen)

Estradiol with medroxyprogesterone

Brand names: Indivina, Tridestra

A combined hormone replacement therapy combining estradiol with the progestogen medroxyprogesterone acetate, used for menopausal symptom relief in women who have a uterus.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Estradiol restores oestrogenic activity to relieve menopausal symptoms while medroxyprogesterone acetate counters oestrogen-induced endometrial proliferation to protect the endometrium.

Prescribing in practice

  • The medroxyprogesterone component is required to prevent endometrial hyperplasia and carcinoma from unopposed oestrogen in women with an intact uterus.
  • Evaluate venous thromboembolism, stroke and breast cancer risk before initiation and review at least annually.
  • Avoid in active or previous thromboembolic disease, oestrogen-dependent cancers and undiagnosed vaginal bleeding.

Monitoring

Review symptoms, blood pressure and bleeding pattern periodically, and investigate any unscheduled vaginal bleeding.

Counselling the patient

  • Report unexpected vaginal bleeding, new breast lumps, or possible clot symptoms.
  • Take the combined preparation as prescribed and do not omit the progestogen component.
  • Continue to attend breast and cervical screening when invited.

Evidence & guidelines

Combined oestrogen-progestogen hormone replacement therapy is supported by NICE menopause guidance for symptom control with individualised risk assessment.

Reference: NICE NG23; British Menopause Society; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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