Reviewed by Dr Samantha Miller MB ChB
(2017, University of Glasgow)
GMC number: 7561464
Information last reviewed 07/06/2021
Elleste Duet is a form of hormone replacement therapy (HRT). During menopause, levels of your oestrogen and progesterone hormones are reduced. This can produce menopausal symptoms such as hot flushes and night sweats. A lack of oestrogen can also lead to osteoporosis (a condition in which the bones become weaker). Elleste Duet HRT supplements these hormones to relieve menopausal symptoms and prevent osteoporosis in postmenopausal women.
Elleste Duet is NOT a contraceptive. If you are under 50, or if it is less than 12 months since your last period, you may still need to use additional contraception to avoid pregnancy. Speak to your doctor for advice.
Elleste Duet contains synthetic forms of oestrogen and progesterone hormones. As women approach menopause, their ovaries begin to produce less oestrogen. This can cause symptoms such as irregular periods, mood swings, hot flushes and night sweats. Elleste Duet supplements these falling hormone levels which helps to relieve symptoms.
Oestrogen also stimulates the growth of the womb lining. If allowed to build up, this can increase the risk of endometrial cancer. The progestogen supplement in Elleste Duet counters this effect by causing a monthly bleed which reduces the risk of endometrial cancer. Women who have had a hysterectomy or the Mirena coil fitted are not at increased risk of endometrial cancer when taking Elleste Duet.
Declining oestrogen levels can also lead to a weakening of the bones, known as osteoporosis. Elleste Duet 2mg is also used for short-term prevention of osteoporosis in postmenopausal women.
Dose |
1 tablet, taken once daily at the same time each day |
Type of Medicine |
Combined HRT |
Mechanism |
Prevents ovulation, thickens mucus to make it harder for sperm to reach eggs, and prevents egg attachment to the uterus |
Available Size |
84 tablets |
Available Strengths |
1mg or 2mg |
Active Ingredient |
Estradiol hemihydrate & norethisterone acetate |
Price |
From 36p per tablet |
Side Effects |
Can include breast tenderness and pain, headache, painful periods, issues with your menstrual cycle, changes in libido, bloating |
The active ingredients in Elleste Duet are estradiol hemihydrate and norethisterone acetate. These are synthetic versions of oestrogen and progesterone hormones.
The inactive ingredients of Elleste Duet are lactose monohydrate, maize starch, povidone 25, talc, magnesium stearate, hydroxypropylmethylcellose (E464), titanium dioxide (E171), and macrogol 400. Elleste Duet 1mg also contains quinoline yellow (E104) and indigo carmine (E132). Elleste Duet 2mg tablets also contain sunset yellow (E110) or black iron oxide (E172) depending on if they are orange or grey tablets.
A pack of Elleste Duet 1mg contains 16 white tablets containing estradiol hemihydrate (oestrogen) and 12 green tablets containing estradiol hemihydrate and norethisterone (oestrogen and progestogen). You will take one of the 16 white tablets each day, followed by one of the 12 green tablets each day. You will then start a new pack. The Elleste Duet 2mg pack contains 16 orange tablets instead of white tablets and 12 grey tablets instead of the green ones. You’ll start with the orange tablets.
If you no longer have regular bleeds, you can start taking Elleste Duet at any time. If you still experience regular bleeds, start taking Elleste Duet on the first day of your bleed. Start at the beginning of a pack with the white or orange tablets. Start a new pack the day after finishing the last. You should experience a monthly bleed at the beginning of each pack when you stop taking the green or grey tablets.
Swallow one tablet with some water at around the same time each day. It helps to make this a part of your daily routine – try taking your pill with breakfast every day, or when you brush your teeth.
If you forget to take a dose, try and take it within the next 12 hours. If 12 hours have already passed when you remember, just skip the dose and take the next one at the normal time. Never take a double dose to make up for the missed one.
Always take Elleste Duet as instructed by your doctor. The recommended dose is one tablet per day. You should try to take each tablet at roughly the same time each day.
Elleste Duet tablets are designed to be taken in a specific order. For Elleste Duet 1mg, you start by taking one white tablet per day for the first 16 days, followed by one green per day for the next 12 days. The cycle will then repeat when you start a new pack.
For Elleste Duet 2mg, you start by taking one orange tablet per day for 16 days followed by one grey tablet per day for the next 12 days. Then start a new pack.
Like all medications, Elleste Duet may cause side effects in some people. The most common side effects (affecting more than 1 in 10 people) include: headache, breast tenderness, increased period pain and changes in menstrual bleeding.
Other less common side effects, affecting around 10% of women include: digestive disturbances, acne, difficulty sleeping, changes in libido, weight gain, dizziness and breast enlargement.
In rare cases, some people experience severe side effects. Stop taking Elleste Duet and seek immediate medical attention if you experience any of the following side effects:
You should also stop taking Elleste Duet immediately if you become pregnant.
For a full list of side effects, please see the patient information leaflet.
Elleste Duet is not suitable for some people with certain health conditions such as certain allergies, liver disease, or blood clotting problems. It is important that you disclose any conditions to the prescribing doctor. The patient information leaflet contains a list of all the conditions that increase the risk of Elleste Duet.
Some other health conditions such as high blood pressure, diabetes or asthma can increase the risks associated with taking Elleste. It may still be safe to take Elleste if you have these conditions, but you may need more frequent check-ups. Always tell the prescribing doctor about any pre-existing health conditions.
Some medications may interact with Elleste Duet. Always tell your doctor about any medications you are taking, including herbal remedies and over the counter treatments. In particular, some medications for epilepsy, tuberculosis (TB) and HIV are known to interact with Elleste Duet. Herbal remedies containing St John’s wort (hypericum perforatum) can also interact with Elleste Duet.
HRT which contains a progestogen as well as an oestrogen, such as Elleste Duet, has a reduced risk of endometrial cancer compared to oestrogen-only HRT. However, evidence suggests that HRT containing both oestrogen and progesterone could lead to an increased risk of breast cancer. While taking this medication, it is important to regularly check your breasts for any lumps you can see or feel, dimpling of the skin or changes to the nipple, and speak to your doctor if you are concerned.
Lifestyle changes may help you deal with menopausal symptoms. Avoiding caffeine, smoking, alcohol and spicy foods can reduce hot flushes and night sweats. Loose, breathable clothing, may also help you stay more comfortable during this time.
Regular exercise can reduce stress and improve general well-being. Increasing vitamin D intake can also help strengthen your bones, reducing the chance of developing osteoporosis. For those experiencing vaginal dryness, there are many moisturisers and lubricants available, and a pharmacist will be able to give advice on which is best for you.
Elleste Solo contains only estradiol (oestrogen) whereas Elleste Duet contains both estradiol and norethisterone (oestrogen and progesterone). Because it does not contain progesterone, Elleste Solo is only suitable for women who have had a hysterectomy, or who have an intrauterine system (IUS/Mirena coil).
Elleste Duet Conti provides a constant dose of both oestrogen and progestogen every day, meaning you will not experience a monthly bleed. This is in comparison to Elleste Duet which has 16 days of estradiol only and 12 days of estradiol and norethisterone. Elleste Duet is recommended for women who are still having menstrual periods, and Elleste Duet Conti is more suitable for those who have not experienced a natural period for 12 months or more.
There are several different types of HRT that are accessible online from Dr Felix. Trisequens is similar to Elleste, as it is also an oral sequential form of HRT. It differs in that it is triphasic, i.e. contains three different doses of the hormone, rather than two different doses as in Elleste Duet. Sequential HRT is also available in patch form e.g. Evorel Sequi, which may be more suitable for those who suffer side effects from oral preparations. Evorel Sequi contains the same hormones as Elleste Duet – estradiol and norethisterone.
For women who have stopped having menstrual periods for at least a year, a continuous combined formulation is more suitable, such as Elleste Duet Conti or Kliovance also contain synthetic forms of both oestrogen and progestogen and so are suitable for women who have not had a hysterectomy, or who do not have an intrauterine system (IUS) fitted.
Another alternative type of HRT is Tibolone, (brand name Livial), which is a type of steroid which works by activating the oestrogen and progestogen receptors. It is a selective steroid that carries a slightly lower risk of breast cancer.
Hormone replacement therapies containing only oestrogen are also available but are only suitable for women who have had a hysterectomy or who have an IUS (Mirena coil) 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) or in the form of patches to be worn on the skin (Elleste Solo MX80, Elleste Solo MX40, Evorel).
HRT is widely accepted as the most effective treatment for the symptoms of menopause. Some people may choose a herbal supplement as an alternative, although the effectiveness of these treatments is unknown. It is important to speak to a doctor or pharmacist about the effects of different herbal supplements. Some women do not take any treatment for menopausal symptoms.
Elleste Duet contains both a progestogen and an oestrogen hormone. The progestogen hormone reduces the risk of endometrial cancer (cancer affecting the lining of the womb) compared to taking oestrogen-only HRT. For this reason, combined HRT (containing the two hormones) is recommended for women who still have a womb. However, taking oestrogen and progesterone together may increase your risk of breast cancer. The increase in breast cancer risk is small, but it increases the longer you take HRT. For this reason, it is important to check your breasts regularly for any lumps or changes to the skin or nipples. It is important to balance the risks of taking HRT with the benefits, such as symptom relief and a reduced risk of osteoporosis.
Prices from:
Oestrogen-only tablets
Oestrogen-only tablets
Cyclical HRT tablets
Oestrogen-only patches
Continuous combined HRT tablets
Cyclical HRT tablets
Continuous combined HRT tablets
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