If you’re starting Femoston, you may have questions about how to use it and what to expect. This guide explains your treatment, how to use it safely, and when to speak to your clinical team.
What you need to know
Femoston is a sequential combined hormone replacement therapy (HRT); treatment that replaces hormones that fall during menopause. Each 28-day pack contains oestrogen-only tablets followed by tablets containing both oestrogen and dydrogesterone, a progestogen that protects your womb lining.
This guide covers Femoston 1mg/10mg and 2mg/10mg tablets. Take the tablets in the order shown on your pack and start the next pack without a break. A monthly withdrawal bleed; bleeding similar to a period; is expected. This guide covers Femoston, not Femoston-conti.
Always follow your prescription and read the patient information leaflet supplied with your treatment.
What’s in your treatment?
Femoston is a sequential combined HRT that comes in two different strengths. Each 28-day pack contains two types of tablets:
In Femoston 1mg/10mg, this pack contains 14 white tablets containing 1mg of estradiol (an oestrogen), and 14 grey tablets containing both 1mg of estradiol and 10mg of dydrogesterone (a progestogen).
In Femoston 2mg/10mg, this pack contains 14 brick-red tablets with 2mg of estradiol, and 14 yellow tablets with 2mg of estradiol plus 10mg of dydrogesterone (a progestogen).
What is it used for?
Femoston is used to relieve the symptoms of perimenopause (the transition leading up to menopause) and menopause, such as hot flushes, night sweats, mood swings, and vaginal dryness. It is also licensed for the prevention of osteoporosis (weakened bones that are more likely to break) after menopause in women who are at a high risk of future fractures, and for whom other preventative treatments are not suitable.
How long does it take to work?
You may notice an improvement in symptoms within a few weeks, but it can take up to three months to adjust and feel the full benefit. Speak to your clinical team if symptoms aren’t improving.
How to use your treatment
For menopausal symptoms in women with a womb: You should take one tablet by mouth each day, starting within five days of your period (or at any time if you no longer have periods), without a break between packs, at about the same time each day. The days of the week are printed on the back of the blister strips.
Femoston 1mg/10mg
Firstly, the tablets from the part marked with arrow 1 should be taken, then all the tablets from the part marked with arrow 2 should be taken.
You take one white tablet (estradiol only) daily for the first 14 days of the cycle, followed by one grey tablet (estradiol and dydrogesterone) daily for the next 14 days.
This completes a 28-day cycle, after which you start the next pack immediately. A monthly withdrawal bleed, similar to a period, is expected to occur during the second half of the cycle or after you finish the pack.
Femoston 2mg/10mg
Firstly, the tablets from the part marked with arrow 1 should be taken, then all the tablets from the part marked with arrow 2 should be taken.
You take one brick-red tablet (estradiol only) daily for the first 14 days of the cycle, followed by one yellow tablet (estradiol and dydrogesterone) daily for the next 14 days.
This completes a 28-day cycle, after which you start the next pack immediately. A monthly withdrawal bleed, similar to a period, is expected to occur during the second half of the cycle or after you finish the pack.
If you miss a dose
If you forget to take a dose, you should take the dose as soon as possible. If more than 12 hours have elapsed since your dose was due, it is recommended to continue with the next dose without taking the forgotten tablet. The likelihood of unexpected bleeding or spotting may be increased with missed doses, however. Always follow your prescribed instructions and check with your clinical team if you’re unsure.
Your dose and treatment plan
The 1mg/10mg tablet dose of Femoston is a common starting dose for this form of sequential HRT, though your dose may be increased by your clinician prescriber depending on your symptoms and response to treatment. Your clinician will aim to use the lowest effective dose for the shortest time needed to manage your symptoms, with regular reviews.
There are no special dosage requirements for older patients, although experience in treating women over 65 is limited. This medicine is not for use in children.
Contraception, pregnancy, and breastfeeding
This treatment isn’t contraception. You may still need contraception, including if it’s been less than 12 months since your last period or you’re under 50. Ask your clinical team for advice tailored to you.
If you become pregnant, stop treatment immediately and contact your clinician. This treatment isn’t indicated during breastfeeding.
Other important safety information
The progestogen (dydrogesterone) in Femoston is included to protect the womb lining from the effects of oestrogen, which is important if you have not had a hysterectomy (surgery to remove the womb) or are taking any other progesterone treatment.
Side effects and treatment risks
Common side effects of treatment with Femoston include headache, abdominal pain, back pain, and breast tenderness or pain. Irregular bleeding or spotting can occur, especially in the first few months. As an oral (systemic) form of HRT, Femoston is associated with a small increased risk of blood clots (venous thromboembolism), stroke, and breast cancer. The risk of ovarian cancer may also be slightly increased.
These risks are generally small and depend on factors like your age, medical history, and how long you take HRT for. For a full list of side effects, please see the Patient Information Leaflet provided with your medication.
Reviews and ongoing clinical support
Your clinician will review your treatment after three months, then at least once a year. They’ll check your symptoms, side effects, any vaginal bleeding, your weight, and your blood pressure, and decide whether further tests are needed.
Examine your breasts regularly and attend routine screening appointments, including mammograms and cervical screening where appropriate. If you had menopause earlier than expected, discuss how this may affect the benefits and risks of HRT with your clinician.
When to stop treatment and seek medical help
Stop using Femoston and seek urgent medical advice if you develop:
Signs of a blood clot, such as painful swelling in a leg.
Swelling of your face, tongue, or throat, difficulty swallowing, or hives with difficulty breathing — possible signs of a severe allergic reaction.
Yellowing of your skin or eyes (jaundice).
A significant increase in your blood pressure.
A new migraine-type headache.
Pregnancy.
If you have difficulty breathing or another life-threatening symptom, call 999. Don’t wait for an email response.
For planned changes or stopping treatment, speak to your clinician. They may recommend reducing your dose gradually to help prevent menopausal symptoms from returning suddenly.
Conditions that need closer monitoring
Tell your clinical team if you have any of the following conditions, have had them before, or they worsened during pregnancy or previous hormone treatment. You may need closer monitoring because they can return or worsen during treatment.
Meningiomas; tumours in the membranes surrounding the brain and spinal cord; have been reported with Femoston. Your clinician should monitor for signs and symptoms.
If you’re diagnosed with a meningioma, treatment containing estradiol and dydrogesterone must be stopped. Tumour shrinkage has been observed after stopping treatment.
Fibroids (non-cancerous growths in the womb) or endometriosis (tissue similar to the womb lining growing outside the womb)
Risk factors for blood clots
Risk factors for tumours affected by oestrogen, such as breast cancer in a close relative
High blood pressure
Liver conditions, including non-cancerous liver tumours
Diabetes, with or without blood vessel complications
Gallstones
Migraine or (severe) headache
Lupus (an immune-system condition)
A history of thickening of the womb lining
Epilepsy
Asthma
Otosclerosis (a condition affecting the bones in the ear)
How to store your treatment
There are no special storage conditions. Keep out of reach of children.
When to speak to your clinical team
Contact your clinical team if you have questions about your prescribed schedule, side effects, symptoms that aren’t improving, or bleeding that concerns you. For non-urgent questions or to discuss your clinical plan, email [email protected].
Frequently asked questions
Is Femoston the same as Femoston-conti?
No. This guide covers Femoston 1mg/10mg and 2mg/10mg, which use a sequential schedule. Follow the leaflet and instructions for the specific treatment you’ve been prescribed.
Can I change my dose myself?
No. Follow your prescription and speak to your clinical team before changing your dose or treatment schedule.
Is this treatment contraception?
No. Ask your clinical team whether you still need contraception and which options are suitable for you.
Read the patient information leaflet supplied with your treatment for the full list of reasons not to use it, side effects, and precautions. This guide doesn’t replace that leaflet or your clinician’s instructions.