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Estrogen stencil

Estrogen is the main hormone in HRT

Most of the symptoms we experience in perimenopause and menopause are due to fluctuating and falling estrogen levels.

We have receptors for this hormone in almost every part of our body – including our womb, bladder, heart, bones, skin, muscles and brain.

Low estrogen levels are at the heart of most of the classic menopausal symptoms including hot flushes, low moods and body aches.


    How is the Estrogen in HRT given?

    We can replace estrogen either in the form of a tablet, patch or gel.


    There are tablets that contain just estrogen and there are also tablets that contain both estrogen and progesterone.

    Estrogen only tablets
    • Progynova – contains estradiol - fully funded.
    • Ovestin - contains estriol - fully funded
    • Estrofem – contains estradiol - part funded
    • Premarin – contains conjugated equine estrogen - part funded 

    Combination tablets

    (all contain estradiol and norethisterone)

    • Kliogest (higher dose estrogen and continuous progesterone) part funded
    • Kliovance (lower dose estrogen and continuous progesterone) part funded
    • Trisequens (cyclical progesterone) part funded



    These contain estradiol.

    • Estradot/Mylan/Estraderm - Patches are changed twice weekly - fully funded
    • Climara – Patches are changed once weekly- not funded



    • Sandrena – contains estradiol - not funded.
    • Estrogel - contains estradiol - not funded



    This is a localised treatment for the vagina, bladder and pelvic floor only. It helps improve vaginal dryness as well as urinary symptoms and pelvic floor problems. The estrogen does not get absorbed everywhere throughout the body, so it is not classed as HRT. It does not require any progesterone even in women who still have a womb. It can be used alone or alongside HRT.

    • Ovestin cream or pessaries – contains estriol - fully funded


    What is Bio-Identical Estrogen?

    This is estrogen that has the same molecular structure as the estrogen our body naturally produces.
    The following HRT contains bio-identical estrogen:
    • Progynova, Estrofem and Ovestin tablets
    • Estradot and Climara patches
    • Sandrena and Estrogel gels
    • Ovestin cream/pessaries

    How is the Estrogen in HRT derived?

    The majority of HRT we now prescribe is derived from yams, the root vegetable.

    What is the safest way to take Estrogen?

    The safest way to take estrogen is through the skin (called transdermal), as either a patch or a gel. This mimics the way our body delivers estrogen naturally – our ovaries release it straight into the bloodstream, bypassing the gut and liver.


    Can Estrogen be taken alone?

    For women who have had a hysterectomy, it is possible to take estrogen alone. This is called ‘Estrogen-only HRT’ and has been linked to a REDUCED risk of breast cancer.
    Women who still have a womb (and also some women who had a hysterectomy for endometriosis) must take a progesterone as well as the estrogen.
    This is because taking oestrogen alone can stimulate the cells in the womb too much and over many years, this can lead them to become cancerous. The dose of progesterone taken must be enough to protect the womb.
    The only progesterone treatments proven to offer this level of protection are the following:
    • Provera tablets
    • Primolut tablets
    • Utrogestan capsules
    • Mirena coil

    Influence of estrogen