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Combined HRT (body-identical oestrogen + micronised progesterone)

Estradiol with progesterone

Brand names: Bijuve

A combination of estradiol with body-identical micronised progesterone, available as a hormone replacement therapy preparation (including a combined capsule) 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 restores oestrogen levels to relieve menopausal symptoms, while micronised progesterone provides endometrial protection against oestrogen-induced hyperplasia.

Prescribing in practice

  • Micronised progesterone can cause drowsiness, so an oral combined capsule is generally taken at bedtime; warn about sedation, especially with concomitant CNS depressants.
  • As with all HRT, counsel on the small increased risks of VTE, stroke and breast cancer and use the lowest effective dose.
  • Endometrial protection requires the progesterone component in any woman with an intact uterus.

Monitoring

Review symptoms, bleeding pattern and benefit-risk annually, investigating any persistent unscheduled bleeding.

Counselling the patient

  • Take the combined capsule at bedtime as it may make you feel drowsy.
  • Report any unexpected vaginal bleeding.
  • Continue routine breast and cervical screening.

Evidence & guidelines

NICE NG23 supports menopause care, and body-identical micronised progesterone is recognised for endometrial protection in HRT.

Reference: NICE NG23; British Menopause Society; SmPC; 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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