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Ovarian conservation at the time of hysterectomy for benign disease: where is the pendulum now?
18 August 2014: Ovarian conservation at the time of hysterectomy for benign disease has certainly become more common, mainly as the result of the landmark paper of Parker and colleagues. This was a focal point in the beginning of a turnaround in the thinking of many clinicians. Now a new body of work examining a portion of this argument comes from the Cancer Prevention Study-II Nutrition Cohort published in Obstetrics & Gynecology by Gaudet and colleagues. Log in to read more...

This Information Sheet has been developed as a guideline only to approximately equivalent doses of the different HRT products available in 2014. The intention is to help physicians change their patients to higher or lower approximate doses of HRT if needing to tailor therapy, or remain within the same approximate dose if needing to change brands of HRT.

pdfAMS Guide to Equivalent HRT Doses761.31 KB

Products which are underlined are Australia only; products in italics are NZ only.

Products with an * meaning Private/non PBS script.

Oestrogen & progestogen combination HRT

Cyclical oestrogen & progestogen combinations
use these at peri-menopause and until at least 12 months amenorrhoea

Medium dose 

Product

Presentation

 Composition

Trisequens*

tablet

  1 and 2mg oestradiol/1mg norethisterone

Femoston

tablet

2mg oestradiol/10mg dydrogesterone

Estalis sequi 50/140

transdermal patch

  50mcg 17 β oestradiol/140mcg norethisterone acetate (twice weekly application)

Estalis sequi 50/250 (same oestrogen, more progestogen than Estalis sequi 50/140)

transdermal patch

  50mcg 17 β oestradiol/250mcg norethisterone acetate (twice weekly application)

Continuous oestrogen & progestogen combinations
should be used if 12 months since LMP or after 12 months cyclical HRT

Low dose

Product

Presentation

Composition

Angeliq1/2*

tablet

  1mg oestradiol/2mg drospirenone

Kliovance*

tablet

  1mg oestradiol/0.5mg norethisterone

Livial*, Xyvion* (generally suitable for older women or at least 1 year post-menopause)

tablet

  2.5mg tibolone

Medium dose

Kliogest*

tablet

  2mg oestradiol/1mg norethisterone

Premia 2.5 continuous*

tablet

  0.625mg conjugated equine oestrogens/2.5mg medroxyprogesterone acetate

Premia 5 continuous* (same oestrogen, more progestogen than Premia 2.5 continuous)

tablet

  0.625mg conjugated equine oestrogens/5mg medroxyprogesterone acetate

Estalis continuous 50/140

transdermal patch

  50mcg 17 β oestradiol/140mcg norethisterone acetate (twice weekly application)

Estalis continuous 50/250
(same oestrogen, more progestogen than Estalis continuous 50/140)

transdermal patch

  50mcg  17 β oestradiol/250mcg norethisterone acetate (twice weekly application)

Oestrogen only therapy
only use these if patient has had a hysterectomy or in combination with a progestogen or Mirena if intact uterus

Low dose

Product

Presentation

 Composition

Estrofem*

tablet

1mg 17 β oestradiol

Progynova

tablet

1mg oestradiol valerate

Ovestin*

tablet

2mg oestriol

Premarin*

tablet

0.3mg conjugated equine oestrogen

Climara 25,  Femtran 25

transdermal patch

25mcg/24hrs 17 β oestradiol
(weekly application)

Estradot 25 or 37.5

transdermal patch

25 or 37.5mcg/24hrs 17 β oestradiol
(twice weekly application)

Estraderm 25 MX

transdermal patch

25mcg/24hrs 17 β oestradiol
(twice weekly application)

Estraderm 25 MX (to be discontinued mid 2012)

transdermal patch

25mcg/24hrs 17 β oestradiol
(twice weekly application)

Medium dose

Estrofem*, Zumenon

tablet

2mg 17 β oestradiol

Progynova

tablet

2 mg oestradiol valerate

Premarin*

tablet

0.625mg conjugated equine oestrogen

Climara 50,  Femtran 50*

transdermal patch

50mcg/24hrs 17 β oestradiol (weekly application)

Estradot 50, Estraderm 50 MX

transdermal patch

50mcg/24 hours 17β oestradiol
(twice weekly application)

Sandrena

transdermal gel

1mg oestradiol (daily application)

High dose

Climara 75

transdermal patch

75mcg/24hrs oestradiol (weekly application)

Estradot 75, Estradot 100

transdermal patch

75 or 100mcg/24 hours (twice weekly application)

Climara100, Femtran99

transdermal patch

100mcg/24hrs oestradiol (weekly application)

Estraderm 100 MX

transdermal patch

100mcg/24hours 17 β oestradiol (twice weekly application)

Estraderm 100 (to be discontinued mid 2012)

transdermal patch

100mcg/24hours 17 β oestradiol (twice weekly application)

Oestradiol implants - No longer available

Oestrogen only vaginal therapy

Ovestin

cream

1mg/g oestriol

Vagifem

pessary

25mcg oestradiol

Progestogen
suggested alternative doses for use with the oestrogen preparations above where fixed dose therapy is not suitable

Low dose for use with low dose oestrogen

Product

Presentation

Composition

Provera (1/2 of 5mg tablet)

tablet

2.5mg medroxyprogesterone acetate

Provera 2.5 mg tablet*

tablet

2.5mg medroxyprogesterone acetate

Primolut N (1/4 of 5 mg tablet)

tablet

1.25 mg norethisterone

Mirena* (PBS indication for contraception/menorrhagia)

device (5 years)

20mcg/24hrs levonorgestrel

 Low dose progestogen-only contraceptive pills (Microlut* (30mcg levonorgestrel), Noriday*, Micronor* (both 350 mcg norethisterone)) are used by some clinicians in various doses but there is limited data for dosages of these pills required for endometrial protection. 1 mg norethisterone was considered the minimum dose (cyclical or continuous) for adequate endometrial protection when combined with 2mg 17β oestradiol in the Cochrane Review (Cochrane Database Syst Rev. 2009 Apr 15;(2):CS000402). 

Medium dose for use with medium dose oestrogen

Primolut N (1/4 of 5mg tablet)

tablet

1.25mg norethisterone

Provera, Ralovera

tablet

5mg medroxyprogesterone acetate

Uterogestan (NZ only)

capsule

100 mg micronised progesterone

Mirena* (PBS indication for contraception/menorrhagia

device (5 years)

20 mcg/24 hours levonorgestrel

Higher dose (for use in cyclical therapy or continuous therapy with high dose oestrogen)

Primolut N (1/2 5mg tablet)

tablet

2.5mg norethisterone

Provera, Ralovera

tablet

10mg medroxyprogesterone acetate

Uterogestan (NZ only)

capsule

200 mg micronised progesterone

AMS New directions in women's health

Note: Medical and scientific information provided and endorsed by the Australasian Menopause Society might not be relevant to a particular person's circumstances and should always be discussed with that person's own healthcare provider.

This Information Sheet may contain copyright or otherwise protected material. Reproduction of this Information Sheet by Australasian Menopause Society Members and other health professionals for clinical practice is permissible. Any other use of this information (hardcopy and electronic versions) must be agreed to and approved by the Australasian Menopause Society.

Content Updated January 2014

What's New?

  • Members update

    NAMS FTK August 2014; Vitamin D and health issues – questioned benefits; New term will banish stigma, educate providers on postmenopausal problems; Ovarian conservation at the time of hysterectom...
  • Cholesterol drug cuts heart and stroke risks by 30% in diabetic women

    The cholesterol-lowering drug fenofibrate cuts cardiovascular disease risks by 30 per cent in women with type-2 diabetes, a new University of Sydney study reveals. "The finding is good news for women...
  • Soy may help women's hearts if they start early

    A diet rich in soy may help feminine hearts, but timing matters, finds a new study published online Menopause, the journal of The North American Menopause Society. Lifelong soy consumption, similar t...
  • Supplements of calcium and vitamin D may have too much for some older women

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  • HRT substitution questioned

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Features

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    This toolkit for managing the menopause has been endorsed by the International Menopause Society, the Australasian Menopause Society and the Jean Hailes Foundation. A Practitioner’s Toolkit for the M...
  • The menopause transition - out of our comfort zone

    Presenter Natasha Mitchell, Jean Kittson and Professor Martha Hickey discuss all matters menopause in the final program in the ABC Radio National's Women's Health Series that aired on 28 June 2014, ab...
  • Lifestyle advice for healthy ageing

    Menopause is a normal part of ageing. With increasing age the risk of many common illnesses increases. Optimising health at menopause may help to improve healthy physical and emotional health into old...
  • Osteoporosis

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  • Menopause Management

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