HRT_FEM clinical practice

Menopause — Combined HRT (Patches + Progesterone)

Standard combined menopausal HRT: oestradiol patches for symptom relief with cyclical or continuous progesterone for endometrial protection. The NICE 2024 menopause guideline recommends transdermal oestradiol as first-line for lower VTE risk vs oral.

Duration

Steps

3

Total Weeks

6

Route

transdermal

Protocols

2

Source

clinical practice

Protocol Timeline

Step Weeks Dose Compound Note
1 6 100 mcg/day Estradiol Transdermal Patch (Twice-Weekly) 1 x 100 mcg/day patch. Vivelle-Dot: change 2x/week. Climara: change weekly. Check labs at 6 weeks.
2 0 200 mcg/day Estradiol Transdermal Patch (Twice-Weekly) 2-4 patches (200-400 mcg/day) needed for feminizing levels. Lower VTE risk than oral.
1 0 100 mg Progesterone (Oral) 100-200 mg at bedtime. Sedating — allopregnanolone metabolite. Added at Tanner stage 3-4 for breast maturation.

Rationale

Sequential (cyclical) progesterone if still having periods or within 12 months of last period. Continuous combined for those >12 months post-menopause. Micronised progesterone (Utrogestan) preferred over synthetic progestogens for better cardiovascular and breast safety profile.

Compounds Used

Related Tools

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Doseline provides informational tools only. It is not a medical device and does not provide medical advice. Always consult a qualified healthcare provider.