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AMS Guide to MHT/HRT Doses New Zealand only

21 July 2023

This version of the AMS Guide to MHT/HRT Doses is currently under review. Please check back soon for the updated version. 


This Information Sheet has been developed as a guideline only to approximately equivalent doses of the different MHT/HRT products available in New Zealand in March 2022. 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 Pharmac subsidised script products are marked with an *.

pdfAMS Guide to Equivalent MHT/HRT Doses NZ109.55 KB

Cyclical oestrogen and progestogen combination MHT

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

Medium dose    
Product Presentation  Composition
Trisequens* tablet        1 and 2mg oestradiol/1mg norethisterone

Continuous oestrogen and progestogen combinations

Should be used if 12 months since LMP or after 12 months cyclical MHT

Low dose    
Product Presentation Composition
Kliovance* tablet 1mg oestradiol/0.5mg norethistrone
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

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
Utrogestan* capsule 100mg micronised progesterone orally for 25 days out of a 28-day cycle1 or 200mg orally daily for 12 days out of a 28-day cycle
Mirena*
(Pharmac indication for
contraception/menorrhagia)
device (5 years) 20mcg/24hrs levonorgestrel

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). 

Medium dose for use with medium dose oestrogen
Product Presentation  Dose 
Primolut N (1/4 of 5mg tablet) tablet 1.25 mg norethisterone
Provera, Ralovera tablet 5mg medroxyprogesterone acetate
Utrogestan* capsule 100mg micronized progesterone orally 25 days
out of a 28-day cycle1 or
200mg daily for 12 days of a 28-day cycle
Mirena*
(Pharmac indication for
contraception/menorrhagia)
device (5 years) 20mcg/24hrs 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
Utrogestan* capsule 200mg orally daily for 12 days out of a 28-day cycle1.
Safe continuous dose unknown due to insufficient data.
Mirena*
(Pharmac indication for
menorrhagia/anaemia)

device (5 years)
20mcg/24hrs levonorgestrel

1Can be used daily if compliance 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).

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 B oestradiol
Progynova tablet 1mg oestradiol valerate
Premarin* tablet 0.3mg conjugated equine oestrogen
Estradot 25  transdermal patch 25 or 37.5mcg/24hrs 17B oestradiol (twice weekly application)
Climara 25* transdermal patch 25mcg/24hrs 17Β oestradiol (weekly application)
Estrogel*^ gel 0.75mg oestradiol = 1 pump
Medium dose    
Progynova tablet 2mg oestradiol valerate
Estradot 50 transdermal patch   50mcg/24 hours 17B oestradiol (twice weekly application)
Premarin* tablet 0.625mg conjugated equine oestrogens
Sandrena*# gel 1mg oestradiol (daily application)
Climara 50* transdermal patch 50mcg/24hrs 17Β oestradiol (weekly application)
Estrogel*^ gel 1.5mg oestradiol = 2 pumps
High dose    
Estradot 75
Estradot 100
transdermal patch 75 or 100mcg/24 hours (twice weekly application)
Climara 75* transdermal patch 75mcg/24hrs 17Β oestradiol (weekly application)
Climara 100* transdermal patch 100mcg/24hrs 17Β oestradiol (weekly application)
Estrogel*^ gel 2.25mg oestradiol = 3 pumps or 3.0mg oestradiol = 4 pumps
Oestradiol implants - No longer available

Oestrogen only vaginal therapy 

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

Product Presentation Composition
Ovestin
Ovestin
cream
pessary
1mg/g oestriol
0.5mg oestriol
Vagifem Low* pessary 10mcg oestradiol

#Note Sandrena is only available under Section 29 at online pharmacies..
^Note Estrogel is only available under Section 29 direct from supplier Pharmaco.

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 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 March 2022

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