AMS Guide to MHT/HRT Doses Australia only
This Information Sheet has been developed as a guideline only to MHT/HRT products available in Australia in September 2024. Hormone Replacement Therapy (HRT) is now referred to as Menopausal Hormone Therapy (MHT). The intention of this sheet is to help clinicians change their patients to higher or lower approximate doses of MHT if needing to tailor therapy, or remain within the same approximate dose if needing to change brands of MHT. Private/non-PBS script products are marked with an *.
AMS Guide to MHT/HRT Doses Australia116.34 KB
CYCLIC MENOPAUSAL HORMONE THERAPY (MHT)
Use continuous oestrogen and cyclic progestogen combinations at peri-menopause or if less than 12 months amenorrhoea
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LOW DOSE |
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PRODUCT |
PRESENTATION |
COMPOSITION |
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Femoston |
Tablet |
1mg oestradiol/10mg dydrogesterone |
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Estrogel Pro* |
Combination pack of oestradiol transdermal gel, with micronised progesterone capsules. |
1 pump (0.75mg oestradiol hemihydrate) daily, and 2 capsules (200mg) micronised progesterone orally for 12 days out of a 28-day cycle |
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Medium dose |
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Trisequens* |
Tablet |
1 and 2mg oestradiol hemihydrate/1mg norethisterone |
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Femoston |
Tablet |
2mg oestradiol/10mg dydrogesterone |
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Estalis sequi 50/140) |
Transdermal patch |
50mcg 17β oestradiol/140mcg norethisterone acetate (twice weekly application) |
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Estalis sequi 50/250 |
Transdermal patch |
50mcg 17β oestradiol/250mcg norethisterone acetate (twice weekly application) |
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Estrogel Pro* |
Combination pack of oestradiol transdermal gel, with micronised progesterone capsules. |
2 pumps (1.5mg oestradiol hemihydrate) daily, and 2 capsules (200mg) micronised progesterone orally for 12 days out of a 28-day cycle |
CONTINUOUS COMBINED MENOPAUSAL HORMONE THERAPY (MHT)
Should be used if 12 months since LMP or after 12 months cyclical MHT
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LOW DOSE |
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PRODUCT |
PRESENTATION |
COMPOSITION |
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Angeliq1/2* |
Tablet |
1mg oestradiol hemihydrate/2mg drospirenone |
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Femoston-conti* |
Tablet |
1mg oestradiol/5mg dydrogesterone |
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Kliovance* |
Tablet |
1mg oestradiol hemihydrate/0.5mg norethistrone |
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Bijuva* |
Capsule |
1mg oestradiol/100mg micronised progesterone |
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Estrogel Pro* |
Combination pack of oestradiol transdermal gel, with micronised progesterone capsules. |
1 pump (0.75mg oestradiol hemihydrate) daily, and 1 capsule (100mg) micronised progesterone orally for 25 days out of a 28-day cycle^ |
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OTHER LOW DOSE HORMONAL OPTIONS |
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Livial*, Xyvion* |
tablet |
2.5mg tibolone |
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Duavive* (oestrogen/ SERM combination) |
tablet |
0.45mg conjugated equine oestrogens / 20mg bazedoxifene acetate |
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MEDIUM DOSE |
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Kliogest* |
Tablet |
2mg oestradiol hemihydrate/1mg norethistrone |
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Estalis continuous 50/140 |
Transdermal patch |
50mcg 17β oestradiol/140mcg norethisterone acetate (twice weekly application) |
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Estalis continuous 50/250 (same oestrogen, more progestogen than Estalis continuous 50/140) |
Transdermal patch |
50mcg 17β oestradiol/250mcg norethisterone acetate (twice weekly application) |
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Estrogel Pro* |
Combination pack of oestradiol transdermal gel, with micronised progesterone capsules. |
2 pumps (1.5mg oestradiol hemihydrate) daily, and 1 capsule (100mg) micronised progesterone orally for 25 days out of a 28-day cycle^ |
^Can be given daily if adherence is an issue
OESTROGEN ONLY THERAPY:
Only use these if patient has had a hysterectomy or in combination with a progestogen or Mirena if intact uterus
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LOW DOSE |
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PRODUCT |
PRESENTATION |
COMPOSITION |
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Estrofem* |
Tablet |
1mg oestradiol hemihydrate |
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Progynova |
Tablet |
1mg oestradiol valerate |
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Premarin* |
Tablet |
0.3mg conjugated equine oestrogens |
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Estradot 25, Estraderm 25 MX |
Transdermal patch |
25mcg oestradiol hemihydrate (twice weekly application) |
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Estradot 37.5 |
Transdermal patch |
37.5mcg oestradiol hemihydrate (twice weekly application) |
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Estrogel* |
Gel |
0.75mg oestradiol hemihydrate= 1 pump daily |
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Sandrena* |
Gel |
0.5mg oestradiol |
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MEDIUM DOSE |
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Estrofem*, Zumenon |
Tablet |
2mg oestradiol hemihydrate |
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Progynova |
Tablet |
2mg oestradiol |
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Premarin* |
Tablet |
0.625mg conjugated equine oestrogens |
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Estradot 50, Estraderm 50 MX |
Transdermal patch |
50mcg oestradiol (twice weekly application) |
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Sandrena |
Gel |
1mg oestradiol daily |
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Estrogel* |
Gel |
1.5mg oestradiol hemihydrate = 2 pumps daily |
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HIGH DOSE |
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Estradot 75, Estraderm 75 MX |
Transdermal patch |
75 or 100mcg oestradiol hemihydrate (twice weekly application) |
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Estradot 100, Estraderm 100 MX |
Transdermal patch |
100mcg oestradiol hemihydrate (twice weekly application) |
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Estrogel* |
Gel |
2.25mg oestradiol hemihydrate = 3 pumps daily or 3.0mg oestradiol = 4 pumps daily |
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VAGINAL THERAPY |
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| If prescribing vaginal oestrogen rather than systemic hormone therapy, a progestogen is not required. | ||
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PRODUCT |
PRESENTATION |
COMPOSITION |
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Ovestin Ovestin |
Cream Pessary |
0.5mg oestriol = 1 application 0.5mg oestriol |
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Vagifem Low |
Pessary |
10mcg oestradiol hemihydrate |
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Intrarosa |
Pessary |
6.5 mg daily Dehydroepiandrosterone (DHEA) (Prasterone) |
PROGESTOGEN
Suggested alternative doses for use with the oestrogen preparations above where fixed dose therapy is not suitable
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LOW DOSE FOR USE WITH LOW DOSE OESTROGEN |
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PRODUCT |
PRESENTATION |
COMPOSITION |
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Provera (1/2 of 5mg tablet) |
Tablet |
2.5mg medroxyprogesterone acetate |
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Provera 2.5mg tablet* |
Tablet |
2.5mg medroxyprogesterone acetate |
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Primolut N (1/4 of 5mg tablet) |
Tablet |
1.25 mg norethisterone |
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Prometrium* |
Capsule |
100mg micronised progesterone orally for 25 days out of a 28-day cycle1 or 200mg orally daily for 12 days out of a 28-day cycle |
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Mirena*(PBS indication for contraception/menorrhagia) |
Intrauterine system |
Levonorgestrel 52mg (approx. 20mcg daily over 5 years) |
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MEDIUM DOSE FOR USE WITH MEDIUM DOSE OESTROGEN 2 |
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PRODUCT |
PRESENTATION |
DOSE |
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Primolut N (1/4 of 5mg tablet) |
Tablet |
1.25 mg norethisterone |
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Provera, Ralovera |
Tablet |
5mg medroxyprogesterone acetate |
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Prometrium* |
Capsule |
100mg micronised progesterone orally for 25 days out of a 28-day cycle^ or 200mg orally for 12 days out of a 28-day cycle |
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Mirena* (PBS indication for contraception/menorrhagia) |
Intrauterine system |
Levonorgestrel 52mg (approx. 20mcg daily over 5 years) |
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HIGHER DOSE (FOR USE IN CYCLICAL THERAPY OR CONTINUOUS THERAPY WITH HIGH DOSE OESTROGEN)2 |
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Primolut N (1/2 5mg tablet) |
Tablet |
2.5mg norethisterone |
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Provera, Ralovera |
Tablet |
10mg medroxyprogesterone acetate |
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Mirena* (PBS indication for contraception/menorrhagia) |
Intrauterine system |
Levonorgestrel 52mg (approx. 20mcg daily over 5 years) |
Notes
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Can be given daily if adherence is an issue
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Safe continuous or cyclic dose of micronized progesterone for use with oestradiol 2mg tablets is unknown due to insufficient data.
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Safe continuous or cyclic dose of micronised progesterone for use with high dose oestrogen (75mcg patch or higher, or high dose oestrogel gels) is unknown due to insufficient data
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Content Updated October 2024