Climesse

The medicine Climesse is a pill used in HRT, manufactured and marketed for purchase in the UK by Novartis. It contains synthetic hormones, which treat the symptoms of the menopause by supplementing the levels of progestogen and oestrogen in the body. These tablets are taken once daily. How should I take Climesse? Climesse comes in the form of a single tablet, which is taken every day. Side effects If you experience any of the following, seek medical help immediately: unexpected vaginal bleeding or spotting after a period of use, or upon stopping treatment; menstrual pain; swelling and redness in the legs; sudden chest pain; breathing difficulty; pain in your chest which spreads to your arm or neck; rapid increase in blood pressure; breast changes, including the development of lumps. Refer to the PIL for a detailed list.

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About

What is Climesse?

Climesse is a medication used in hormone replacement therapy (HRT) to relieve the symptoms of menopause in women, and to prevent osteoporosis in postmenopausal women. It contains estradiol valerate, a naturally occuring form of oestrogen, and norethisterone, a synthetic form of progesterone. 

How does Climesse work?

Climesse is a form of combined hormone replacement therapy. As women approach menopause, their ovaries produce less and less oestrogen. Declining oestrogen levels in the blood can cause symptoms such as irregular periods, mood swings, hot flushes and sweats. Climesse contains an oestrogen supplement, estradiol valerate, to moderate falling levels and relieve thee symptoms. Oestrogen also stimulates the growth of the womb lining, which can lead to endometrial cancer if allowed to build up. Climesse also contains norethisterone, a synthetic form of progesterone, to counter oestrogen’s effect on the womb lining and reduce the risk of cancer.

Declining levels of oestrogen in women can also cause a weakening of the bones, known as osteoporosis. Climesse is sometimes used to prevent osteoporosis in postmenopausal women.  

How effective is Climesse?

When used correctly, Climesse provides effective relief from the symptoms of menopause and significantly reduces the risk of developing osteoporosis. Climesse is a continuous pill, meaning it is taken without a monthly break for a bleed, and is therefore most effective in postmenopausal women who have not had a period for 12 months.

When does Climesse start to work?

It can take a few weeks to feel the benefits of taking Climesse and up to three months in some cases. During this time, you may also experience some spotting or breakthrough bleeding. In many cases, short-term use of this medication will be sufficient for controlling the symptoms of menopause, but some women continue to use Climesse for several years. Your continued need for this medication should be reviewed by a doctor at least once a year, and women on any form of HRT should go for regular gynaecological check-ups.

Ingredients

Active ingredients

The active ingredients in Climesse tablets are oestradiol valerate and norethisterone.

Inactive ingredients

The inactive ingredients in Climesse tablets are lactose, maize starch, povidone, talc, magnesium stearate, hydroxypropylmethylcellulose and propylene glycol. Colouring in the tablets is E171 and E172.

Dosage

Climesse dosage

The normal dosage for Climesse is 1 x 2mg tablet taken at the same time each day.

How to start Climesse

You should not start Climesse until at least 12 months after your last natural period. If you have previously been taking an alternative hormone replacement therapy medication, you should carry on taking this pill until the end of the monthly pack. Start taking the Climesse tablets the next day WITHOUT leaving a break between pills.

If you have not been taking any alternative hormone replacement therapy, you can start taking Climesse on any day of the month.  

How to take Climesse

You should swallow one 2mg tablet of Climesse at the same time each day. Try and make this a part of your daily routine - for example, you might wish to take your pill with breakfast every day, or when you brush your teeth. When you reach the end of the monthly pack, start the next pack immediately without taking a break between packs. 

What should I do if I took a pill too late?

Always try and take your pill at the same time each day, or within 12 hours of this time if you forget. If you do take a the pill more than 12 hours after your normal time, don’t worry. You can still take your next pill at the normal time. This is unlikely to do you any harm on a one-off occasion, but do speak to your doctor if you experience any unpleasant side effects. 

What should I do if I missed a pill?

If you miss a pill, try and take it within the next 12 hours. If 12 hours have already passed, just skip the dose and take the next one at your usual time. You should never double-up a dose to compensate for the missed pill.

Side Effects

Climesse side effects

As with all medicines, Climesse can cause some side effects. You should stop taking your tablets and tell your doctor immediately if you experience severe headaches or symptoms of jaundice (yellowing of the skin or whites of the eyes). Other side effects may include:

  • Breast tenderness or enlargement
  • Weight gain
  • Wind, stomach pains or bloated feeling
  • Stomach pains, nausea or sickness
  • Dizziness or irritability
  • Skin rash
  • Increase in vaginal fluid
  • High blood pressure or palpitations
  • Headaches or muscle cramps
  • Change in sexual desire
  • Spots
  • Feeling tired or depressed

If you are worried about any side effects of Climmesse, consult your doctor for advice.   

Contraindications

You should not take Climesse tablets if:

  • You are pregnant, think you might be pregnant or are breastfeeding.
  • You have ever had breast cancer or any lumps in your breast not considered by a medical professional to be harmless.
  • You have or might have any type of cancer that is sensitive to hormones.
  • You are experiencing unusual vaginal bleeding.
  • You have thrombosis (problems with circulation) or embolism (blood clotting too easily). Characteristics are red sores over your veins, or pains in your chest and legs when you walk.
  • You have levere heart, liver or kidney problems.
  • You are allergic to any of the ingredients in Cilmesse

Before taking Climesse, inform your doctor if:

  • You have gallstones or mild liver disease.
  • You have or have had jaundice, Dubin-Johnson syndrome or Rotor syndrome.
  • You have porphyria.
  • You have hearing loss due to otosclerosis.
  • You experience migraines or are epileptic.
  • You have cysts or nodules in your breast.
  • You have problems with your womb, such as endometriosis or fibroids.
  • You have multiple sclerosis.
  • You have diabetes
  • You have systemic lupus erythematosus.
  • You have hypertension (high blood pressure)  

Drug interactions

Climesse is unlikely to react with other medicines, as the hormones it includes are designed to supplement your own natural hormones. However, you should tell your doctor about any other medications you are taking, including those bought over the counter without a prescription.

Climesse and alcohol

Alcohol should be drunk in moderation and with caution while taking this medication.

Treatment Options

Alternatives to Climesse

There are several different types of hormone replacement therapy that are accessible via prescription from the NHS, or purchased online following an online consultation with a Dr Felix doctor. Like Climesse, Elleste Duet and Elleste Duet Conti contain synthetic forms of both oestrogen and progesterone and are suitable for women who have not had a hysterectomy, or who do not have an intrauterine system (IUS), or coil, fitted. Elleste Duet is suitable for women who are still experiencing regular bleeds during the onset of menopause. Tibolone, brand name Livial, is a type of steroid which works by activating the oestrogen and progesterone receptors. It is a selective steroid which carries a slightly lower risk of breast cancer. 

Hormone replacement therapies containing oestrogen only are also available, but are only suitable for women who have had a hysterectomy or who have a IUS fitted. An IUS will do the job of providing the progesterone needed to counteract the risk of endometrial cancer associated with oestrogen supplements. Oestrogen only therapies can be purchased in tablet form (Premarin, Elleste Solo, Kliovance) or in the form of patches to be worn on the skin (Elleste Solo MX80, Elleste Solo MX40, Evorel).

Climesse vs other forms of HRT

There are several different types of HRT available for the treatment of menopause, and your doctor will be able to help you decide which is best for you. Like Climesse, Elleste Duet, Elleste Duet Conti and Kliovance contain synthetic forms of both oestrogen and progesterone, and are therefore suitable for women who have not had a hysterectomy, or do not have an IUS fitted. Elleste Duet is more suited to women who still experience regular periods, while Elleste Duet Conti and Kliovance, like Climesse, does not allow for a monthly bleed and is better suited to women who have not had a period in the last 12 months.

 

For women who have had a hysterectomy, or who have an IUS fitted, HRTs containing an oestrogen synthetic only are also available. These can be purchased as an oral medication (Premarin, Elleste Solo) or as transdermal patches which are applied to the skin (Elleste Solo MX80, Elleste Solo MX40, Evorel).

Another alternative is Tibolone, brand name Livial, a selective steroid which works by activating oestrogen and progesterone receptors in the body. Livial carries a slightly lower risk of breast cancer than other HRTs.

Alternatives to HRT

HRT is widely regarded as the best treatment for the symptoms of menopause, and is easily accessible both from the NHS and online from Dr Felix. Some women may choose to try herbal supplements as an alternative means of relieving their symptoms, although the effectiveness of such treatments is unknown. Make sure to speak to a doctor of pharmacist about the effects of different herbal supplements before trying them.

Lifestyle changes to improve menopause symptoms

Menopause can be made more bearable with a few simple lifestyle changes. Increasing your intake of vitamin D, which is essential for the absorption of calcium, will help to keep your bones strong, and exercising regularly will improve your general health and help to relieve stress. Discomfort caused by vaginal dryness can be managed by purchasing moisturisers and lubricants from any pharmacy, and your pharmacist will be able to choose which is best or you. To lessen the impact of hot flushes and night sweats, try cutting down on caffeine, alcohol and spicy foods, and if you smoke, try and quit. Even if you are using HRT, these measures will help you feel the benefits and contribute to your overall wellbeing. 

Q&A

If I have vomited, will Climesse still work?

If you vomit soon after taking your Climesse pill, it is unlikely that it will have had time to be absorbed into your system. If you feel well enough, try and take your pill within the next 12 hours. If not, just skip the dose and take your next pill at the normal time. 

Is Climesse bioidentical?

Climesse is not bioidentical because it contains norethisterone, which is a synthetic rather than naturally-occuring form of progesterone.

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