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Combined HRT (oestrogen + progestogen)

Estradiol with norethisterone

Brand names: Kliovance, Novofem, Elleste Duet, Evorel Conti, Evorel Sequi

A combination of estradiol (oestrogen) with norethisterone (a progestogen) used most commonly as a continuous or sequential hormone replacement therapy preparation for menopausal symptoms in women with 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 replaces declining endogenous oestrogen to relieve vasomotor and urogenital symptoms, while norethisterone provides endometrial protection by opposing oestrogen-driven endometrial proliferation.

Prescribing in practice

  • HRT is associated with a small increased risk of venous thromboembolism, stroke and breast cancer; discuss individualised benefit-risk and use the lowest effective dose for the shortest appropriate duration.
  • The progestogen component is essential in women with an intact uterus to prevent endometrial hyperplasia and carcinoma.
  • Investigate any unscheduled or persistent bleeding, particularly after the initial settling period.

Monitoring

Review symptom control, bleeding pattern, blood pressure and ongoing benefit-risk at least annually.

Counselling the patient

  • Report any unexpected vaginal bleeding to your clinician.
  • Continue breast and cervical screening as recommended for your age.
  • Seek urgent advice for signs of clot such as leg swelling, chest pain or breathlessness.

Evidence & guidelines

NICE NG23 guides menopause management and the individualised discussion of HRT benefits and risks.

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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