AMS Guide to Equivalent MHT/HRT Doses Australia only

This Information Sheet has been developed as a guideline only to approximately equivalent doses of the different MHT/HRT products available in Australia in August 2022. Hormone Replacement Therapy (HRT) is now referred to as Menopausal Hormone Therapy (MHT). The intention of this sheet is to help physicians 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 *

pdfAMS Guide to Equivalent MHT/HRT Doses Australia

Cyclic Menopausal Hormone Therapy (MHT)

Use continuous oestrogen and cyclic progestogen combinations at peri-menopause or if less than 12 months amenorrhoea

Low Dose

   

Product

Presentation

Composition

Femoston

tablet

1mg oestradiol/10mg dydrogesterone

Estrogel Pro*

Combination pack of oestradiol transdermal gel, with micronised progesterone capsules.

1 pump (0.75mg oestradiol) daily, and 2 capsules (200mg) micronised progesterone orally for 12 days out of a 28-day cycle

Medium dose

   

Trisequens*

tablet

1 and 2mg oestradiol/1mg norethisterone

Femoston

tablet

2mg oestradiol/10mg dydrogesterone

Estalis sequi 50/140)

transdermal patch

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

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

transdermal patch

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

Estrogel Pro*

Combination pack of oestradiol transdermal gel, with micronised progesterone capsules.

2 pumps (1.5mg oestradiol) 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

Low dose

   

Product

Presentation

Composition

Angeliq1/2*

tablet

1mg oestradiol/2mg drospirenone

Femoston-conti

tablet

1mg oestradiol/5mg dydrogesterone

Kliovance*

tablet

1mg oestradiol/0.5mg norethistrone

Bijuva*

capsule

1mg oestradiol/100mg micronised progesterone

Estrogel Pro*

Combination pack of oestradiol transdermal gel, with micronised progesterone capsules.

1 pump (0.75mg oestradiol) daily, and 1 capsule (100mg) micronised progesterone orally for 25 days out of a 28-day cycle^

Other Low dose hormonal options

Livial*, Xyvion*

tablet

2.5mg tibolone

Duavive* (oestrogen/ SERM combination)

tablet

0.45mg conjugated equine oestrogens / 20mg bazedoxifene

Medium dose

   

Kliogest*

tablet

2mg oestradiol/1mg norethistrone

Estalis continuous 50/140

transdermal patch

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

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

transdermal patch

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

Estrogel Pro*

Combination pack of oestradiol transdermal gel, with micronised progesterone capsules.

2 pumps (1.5mg oestradiol) 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 

Low dose

   

Product

Presentation

Composition

Estrofem*

tablet

1mg oestradiol

Progynova

tablet

1mg oestradiol

Premarin*

tablet

0.3mg conjugated equine oestrogen

Climara 25

transdermal patch

25mcg oestradiol (weekly application)

Estradot 25 or 37.5

transdermal patch

25 or 37.5mcg oestradiol (twice weekly application)

Estraderm 25 MX

transdermal patch

25mcg oestradiol (twice weekly application)

Estrogel*

gel

0.75mg oestradiol = 1 pump daily

Medium dose

   

Estrofem*, Zumenon

tablet

2mg oestradiol

Progynova

tablet

2mg oestradiol

Premarin*

tablet

0.625mg conjugated equine oestrogens

Climara 50

transdermal patch

50mcg oestradiol (weekly application)

Estradot 50, Estraderm 50 MX

transdermal patch

50mcg oestradiol (twice weekly application)

Sandrena

gel

1mg oestradiol daily

Estrogel*

gel

1.5mg oestradiol = 2 pumps daily

High dose

   

Climara 75

transdermal patch

75mcg oestradiol (weekly application)

Estradot 75, Estradot 100

transdermal patch

75 or 100mcg (twice weekly application)

Climara 100

transdermal patch

100mcg oestradiol (weekly application)

Estraderm 100 MX

transdermal patch

100mcg oestradiol (twice weekly application)

Estrogel*

gel

2.25mg oestradiol = 3 pumps daily or 3.0mg oestradiol = 4 pumps daily

Oestrogen only vaginal therapy
If prescribing vaginal oestrogen rather than systemic hormone therapy, a progestogen is not required.

Product

Presentation

Composition

Ovestin

cream

0.5mg oestriol = 1 application

Ovestin

pessary 0.5mg oestriol

Vagifem Low

pessary

10mcg 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 2.5mg tablet*

tablet

2.5mg medroxyprogesterone acetate

Primolut N (1/4 of 5mg tablet)

tablet

1.25 mg norethisterone

Prometrium*

capsule

100mg micronised progesterone orally for 25 days out of a 28-day cycle^ or 200mg orally daily for 12 days out of a 28-day cycle

Mirena*(PBS indication for contraception/menorrhagia)

device

(5 years)

20mcg levonorgestrel

Medium dose for use with medium dose oestrogen

Product

Presentation

Composition

Primolut N (1/4 of 5mg tablet)

tablet

1.25 mg norethisterone

Provera, Ralovera

tablet

5mg medroxyprogesterone acetate

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

Mirena*(PBS indication for  contraception/menorrhagia)

device

20mcg levonorgestrel (5 years)

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

Product

Presentation

Dose

Primolut N (1/2 5mg tablet) tablet 2.5mg norethisterone

Provera, Ralovera

tablet

10mg medroxyprogesterone acetate

Prometrium*

capsule

200mg micronised progesterone orally daily for 12 days out of a 28-day cycle. Safe continuous dose unknown due to insufficient data

Mirena*(PBS indication for contraception/menorrhagia)

device

20mcg levonorgestrel (5 years)

^Can be given daily if adherence is an issue

Low dose progestogen-only contraceptive pills (Microlut (30mcg levonorgestrel), and Noriday (350mcg 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 in the Cochrane Review (Cochrane Database Syst Rev. 2009 Apr 15;(2):CS000402).

© Australasian Menopause Society Ltd

AMS Empowering Menopausal Women

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 contains copyright or otherwise protected material. Reproduction of this Information Sheet by Australasian Menopause Society Members and other health professionals for clinical practice is permissible. No other reproduction or transmission is permitted in any form or by any information storage and retrieval systems except as permitted under the Copyright Act 1968 or with prior written permission from the copyright owner. ID:2022-08-19

Content Updated August 2022

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