Oestrogen tablets, patches, gel and spray - Common brands: Oestrogel, Evorel, Sandrena, Lenzetto, Estradot, Progynova

What oestrogen is for

During menopause, your body starts to make less of a hormone called oestrogen, which can cause symptoms.

Oestrogen is used to help ease menopause symptoms such as:

• hot flushes and night sweats
• vaginal dryness, itching or pain
• sleep problems

If you still have a womb, you will need to use oestrogen along with a hormone called progestogen. This is to help protect your womb lining.

If you've had your womb removed (a hysterectomy), you will not need to use progestogen.

How to take or use oestrogen

Oestrogen comes as tablets, patches, a gel and a spray.

When you use or take oestrogen:

• how you use it, how much and for how long depends on whether you still have regular periods, your symptoms and if you still have a womb
• talk to a doctor if your symptoms are not getting better – it can take time to find the right type and dose to suit you

Always follow your doctor's instructions and the instructions on the leaflet that comes with your medicine.

How to use different types of oestrogen

If you miss a dose of oestrogen

Tablets, spray and gel

If you miss a dose of oestrogen and it's more than 12 hours until your next dose, take or use it as soon as you remember.

If it's less than 12 hours until your next dose, skip the missed dose and take or use the next dose at the normal time.

If you miss a dose, you may have some bleeding or spotting.

Do not take or use 2 doses of your oestrogen to make up for a forgotten dose.

Oestrogen patches

If you forget to change your HRT patch, change it as soon as you remember. Continue the same days that you change your patch.

If you use too much oestrogen

Using too much oestrogen is unlikely to cause problems, but it's important to get medical advice if you take too much as it can sometimes be dangerous. It can also increase the risk of side effects such as breast tenderness, feeling sick (nausea) and vaginal bleeding.

How to stop using oestrogen

When you start using HRT, your GP should review your medicine after the first 3 months.

If you want to stop at any point, talk to your GP, but stopping may cause your symptoms to come back.

If you want to carry on using oestrogen, you can usually do so for long as it helps your symptoms.

Side effects of oestrogen

Like all medicines, oestrogen can cause side effects, although not everyone gets them.

Common side effects

Common side effects of oestrogen may include:

• headaches
• breast pain or tenderness
• skin irritation where you stick patches
• unexpected vaginal bleeding or spotting, or heavier periods than usual

Oestrogen will not usually affect your ability to drive, ride a bike or use machinery.

Serious side effects

Oestrogen can sometimes cause serious side effects, although most of them are rare.

• pain and swelling in your legs (this may be a sign of DVT (deep vein thrombosis), or sudden chest pain or difficulty breathing (these may be signs of pulmonary embolism
• yellowing of your eyes and skin, which may be harder to see on brown or black skin – these may be signs of jaundice
• weakness on 1 side of the face (the mouth or eye may droop), difficulty raising the arms and keeping them raised, difficulty speaking (speech may be slower) – these may be symptoms of a stroke
• an allergic reaction (anaphylaxis) – which can cause symptoms such as a swollen throat or tongue, a raised, itchy rash or difficulty breathing

There is also an increased risk of breast cancer and womb (uterus) cancer, particularly if you take oestrogen for a long time. Your GP will talk to you about the risks and benefits.

Who can and cannot use oestrogen

Most adults can use oestrogen.

But it is not suitable for everyone. For example, it may not be suitable if:

• you've had an allergic reaction or other serious side effect from oestrogen
• you've ever had breast cancer, are having tests for breast cancer or are at high risk due to family history
• you have vaginal bleeding with no known cause
• you've ever had deep vein thrombosis (DVT) or pulmonary embolism

Before using oestrogen tell your GP if you have any medical conditions.

Breastfeeding and oestrogen

Tell your doctor if you're breastfeeding. Oestrogen is not recommended if you're breastfeeding.

Pregnancy and oestrogen

Tell your doctor if you're pregnant or trying to get pregnant. Oestrogen is not recommended during pregnancy.

Using oestrogen with other medicines, food and drink

There are some medicines, remedies and supplements that may not mix well with oestrogen.

These include:

• medicines or epilepsy, such as phenytoin or carbamazepine
• certain medicines for infections, such as rifampicin
• medicines for HIV such as antiretrovirals
• herbal remedies containing St John's wort

Before taking or using oestrogen, tell your doctor if you're taking any other medicines, herbal remedies, vitamins or supplements.

Food, drink and alcohol with oestrogen

You can eat and drink as normal while using oestrogen.