Elleste Duet is a sequential combined hormone replacement therapy (HRT), treatment that replaces hormones that fall during menopause. It contains oestrogen throughout each 28-day cycle, with a progestogen (a hormone that protects your womb lining) added for part of the cycle.
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This guide covers Elleste Duet 1mg and 2mg tablets. Take the tablets in the order shown on your pack, with no break between packs. A monthly withdrawal bleed -bleeding similar to a period- is expected.
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Always follow your prescription and read the patient information leaflet supplied with your treatment.
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Elleste Duet is a sequential combined HRT. Each 28-day pack contains two types of tablets:

Elleste Duet 1mg is used for the relief of menopausal symptoms in women who still have a womb and are experiencing a menstrual cycle, however irregular. Elleste Duet 2mg is used for the relief of menopausal symptoms and is also licensed for the prevention of osteoporosis (weakened bones that are more likely to break) after menopause in women at high risk of fractures. It is suitable for women who require a higher dose of oestrogen for symptom control.
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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.
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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. If you are changing to Elleste Duet from a continuous Combined HRT preparation, you may start therapy at any time if you no longer have periods, or otherwise start on the first day of bleeding. Follow the arrows on the pack.
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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.
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The 1mg tablet dose of Elleste Duet is a standard starting dose for sequential HRT, though your clinician may adjust this dose over time depending on your 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.
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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.
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The progestogen (norethisterone) in Elleste Duet 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.
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Common side effects 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, Elleste Duet 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.
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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.
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Stop using Elleste Duet and seek urgent medical advice if you develop:

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.
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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.

Do not store above 30°C. Store in the original package. Keep out of reach of children.
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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].

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.
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A monthly withdrawal bleed is expected towards the end of, or after, the combined-hormone tablets. Speak to your clinical team about bleeding that concerns you.

No. Follow your prescription and speak to your clinical team before changing your dose or treatment schedule.

No. Ask your clinical team whether you still need contraception and which options are suitable for you.

Do not store above 30°C. Store in the original package. Keep out of reach of children.

Further information:

If you have questions about your medication, wish to discuss alternative treatment plans, or need reassurance, our clinicians are available to provide expert advice and support. Just email us at [email protected].

Lastly, please read the Patient Information Leaflet linked below and included with your treatment for a full list of side effects, contraindications, and precautions.