Elleste Solo

What is Elleste Solo?

Elleste Solo is a hormone replacement therapy (HRT). It contains estradiol, a form of oestrogen, and is used to supplement falling levels of oestrogen in women, relieving the symptoms of menopause.

It 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 GP for advice.  

How does it work?

The treatment contains estradiol, a form of the female hormone oestrogen. During menopause, the level of oestrogen naturally produced by the ovaries decreases, causing symptoms such as hot flushes and sweats, irregular periods, mood swings and reduced libido. Menopause can also cause a weakening of the bones, known as osteoporosis. HRT works by supplementing the natural levels of oestrogen in women, relieving symptoms of menopause and temporarily preventing osteoporosis.

Increasing the level of oestrogen in the body causes the womb lining to thicken, which significantly increases the risk of endometrial cancer. Therefore this oestrogen-only HRT preparation is only suitable for women who have had a hysterectomy, or who have a Mirena intrauterine system (IUS) fitted.

Active ingredients

The active ingredient in all formulations of Elleste Solo is estradiol hemihydrate.

Inactive ingredients

In Elleste Solo tablets: lactose monohydrate, maize starch, povidone, talc, magnesium stearate, macrogol 400, titanium dioxide (E171), and hydroxypropylmethyl cellulose (E464). The 2 mg tablets also contain the colouring sunset yellow (E110).  

In Elleste Solo transdermal patches: diethyltoluamide, acrylic adhesive (Dow Corning MG-0560), acrylic emulsion (Acrysol 33), polyester film (Scotchpak 9733), siliconised aluminised polyester.

How to use Elleste Solo?

Elleste Solo 1mg or 2mg Tablets:

If you still have regular periods, start taking the tablets on the first day of your period. If you no longer have regular periods, you can start taking Elleste Solo tablets at any time. 

• You should take one tablet each day at around the same time. 
• Tablets should be swallowed whole and taken with water.
• Follow the direction of the arrows and the days of the week that are marked on the pack and take a tablet each day until the pack is empty. 
• When you finish a pack, start the next pack on the next day.

If you forget to take a dose, try and take it within 12 hours of the normal time. If 12 hours has already passed, don’t worry, just take the next dose at the normal time. Never take a double dose to make up for a missed one. 

If you are switching from another form of HRT, speak to your doctor on how to switch treatments. It is usually recommended to finish the current pack of your previous treatment before starting a new one.

Elleste Solo MX40 or MX80 transdermal patches:

Always use medications as instructed by the prescribing doctor. The usual dose is to use two patches a week. These should be applied one at a time and left on the skin for 3–4 days, before being replaced with the second patch. 

• The patch should be placed on dry, unbroken skin, below the waistline (the lower back or buttocks are common places to use).
• Do not place your new patch in the same place you have just used it.
• Do not apply the patch to your breast. 

If you have regular periods, apply the first patch within 5 days of the start of your period. If you are not having regular periods, you can start using the patches at any time. If you are changing from another type of HRT, you should generally finish one treatment cycle before starting Elleste Solo. You should speak to your doctor for clarification.

Dosage Information

Elleste Solo Tablets:

Elleste Solo Patches:

Elleste Solo Side Effects

Like all medications, this treatment can cause side effects in some people. Common side effects (affecting up to 1 in 10 people) can include:

• Nausea
• Stomach cramps
• Headaches
• An increase in the size of fibroids in the womb
• Breakthrough bleeding
• Weight changes
• Swelling of the legs
• Breast tenderness or enlargement
• Mood swings
• Changes in libido
• Skin irritation where patches are applied

Uncommon side effects, which can affect up to 1 in 100 people, include:

• Sickness
• Indigestion
• Flatulence
• Gallstones or gallbladder disease
• Dizziness
• Migraines
• Vaginal thrush
• Increase in blood pressure
• Leg cramps

Rare side effects experienced by less than 1 in 1000 people include:

• Loss of hair from the scalp
• Increase in body hair or facial hair
• Itchiness or rashes

Additionally, there is a slight increase in the risk of developing the following conditions in certain women using HRT:

• Breast cancer
• Endometrial hyperplasia
• Endometrial cancer
• Ovarian cancer
• Venous thromboembolism (blood clots in the legs or lungs)
• Heart disease
• Stroke
• Memory loss in those over the age of 65.

Contraindications

Always consult a doctor before taking this or any other form of HRT. Do NOT take this medication if you:

• Are allergic to any of the ingredients
• Have or have ever had breast cancer
• Have or have ever had endometrial cancer, or any other cancer which is sensitive to oestrogen
• Are experiencing unexplained vaginal bleeding
• Have endometrial hyperplasia (excessive thickening of the womb lining) which is not being treated
• Have or have ever had thrombosis (blood clot in the vein e.g. a pulmonary embolism or deep venous thrombosis)
• Have a blood clotting disorder
• Have or have recently had a disease caused by blood clots in the arteries e.g. angina or heart attack
• Have liver disease, or have had liver disease in the past and your test results have not returned to normal
• Have porphyria
• Are pregnant, or think you might be
• Are breastfeeding.

Speak to your doctor if you have any questions about the conditions listed above. You should also tell your doctor and take extra care when taking this medication if you have any of the following, as you may need to see your doctor more often for medical check-ups:

• Fibroids inside your womb
• Endometriosis (growth of the womb lining outside of the womb) or endometrial hyperplasia (excessive growth of the womb lining)
• Increased risk of developing thrombosis (blood clots)
• Increased risk of developing oestrogen-sensitive cancers e.g. a family history of breast cancer 
• High blood pressure
• A liver disorder
• Diabetes
• Gallstones
• Migraines or severe headaches
• A disease of the immune system
• Epilepsy
• Asthma
• Otosclerosis (a disease affecting the eardrum or hearing)
• Triglycerides (high level of fat in your blood)
• Fluid retention due to kidney or cardiac problems.

You should stop taking Elleste Solo immediately and consult your doctor if you notice:

• Any of the conditions listed above
• Jaundice (yellowing of the skin or whites of the eyes). This could be a sign of liver disease.
• A significant rise in blood pressure, characterised by headaches, tiredness, dizziness.
• Migraine-like headaches
• You become pregnant.
• Painful swelling of the calf
• Sudden chest pain
• Difficulty breathing
• Cough with blood-stained sputum.

Drug interactions

Before taking this treatment, tell your doctor if you are taking any other medications, including those bought over the counter without a prescription. In particular, the following medicines may interact with Elleste Solo:

• Epilepsy medications, such as phenobarbital, phenytoin and carbamazepine
• Tuberculosis medications, such as rifampicin and rifabutin
• Medications for HIV infection, such as nevirapine, efavirenz, ritonavir, telaprevir and nelfinavir
• Coumarins, lamotrigine, and selegiline
• Herbal remedies containing St John’s Wort (hypericum perforatum)

Lifestyle changes to improve menopause symptoms

Certain lifestyle changes can help to manage the symptoms of menopause and increase the effectiveness of HRT. Cutting down on caffeine, alcohol and spicy foods, as well as quitting smoking and wearing loose-fitting clothes, can help reduce the impact of hot flushes and night sweats. Regular exercise is known to reduce stress, as well as strengthening your bones and improving your general wellbeing. You can increase your intake of vitamin D, which is vital for the absorption of calcium, to help keep your bones strong and healthy. Vaginal moisturisers and lubricants can help with vaginal dryness and can be bought in any chemist with the help of a pharmacist.

Alternatives to HRT

HRT is the most widely used treatment for the symptoms of menopause and is generally accepted to be the most effective option. Some women choose to try taking herbal supplements, 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.

Elleste Solo vs. Elleste Duet

Elleste Solo only contains estradiol (an oestrogen) whereas Elleste Duet contains estradiol and norethisterone acetate (a progestogen). Elleste Duet is, therefore, a suitable option for women who have a uterus and would therefore be at risk of excessive thickening of the womb lining with oestrogen alone. Elleste Duet is a cyclical combined HRT formulation, which allows for a monthly bleed, so it’s suitable for women who still experience regular periods, or who have had a natural period within the last 12 months.

Elleste Solo MX vs. Elleste Solo

Elleste Solo is a tablet oestrogen-only HRT preparation which comes in either a 1mg or 2mg dose. Elleste Solo MX40 and MX80 are transdermal (patch) formulations of the same hormone. Transdermal patches are applied twice per week and release a steady dose of oestrogen into the bloodstream. They work in the same way as the tablets, however tend to have fewer side effects, and are not associated with an increased risk of blood clots like tablets. You can speak to your doctor for advice on which treatment is best for you.

Elleste Solo vs. other forms of HRT

HRT comes in many different forms that are available online from Dr Felix. Similar to Elleste Solo, Premarin is an oestrogen-only HRT, however, it contains conjugated oestrogens rather than estradiol. Premarin is also only suitable for use in women who have had a hysterectomy or who have an IUS fitted. Oestrogen-only HRT is also available as transdermal patches such as Evorel, which are worn on the skin and tend to have fewer side effects.

For women who have not undergone a hysterectomy, and do not have an IUS fitted, HRT containing both oestrogen and progesterone are more suitable. For women who have not had a bleed for at least 12 months, Elleste Duet Conti, Climesse and Kliovance are tablet forms of continuous combined HRT that do not induce a monthly bleed. If a patch is preferred, Evorel Conti is a transdermal continuous combined HRT.

For those still having periods, Elleste Duet, Prempack-C and Trisequens are cyclical or “sequential” combined HRT which provide a cyclical dose of progestogen, which will produce a regular bleed. Cyclical combined patches are also available such as Evorel Sequi. 

Alternatively, Tibolone (brand name Livial) is a type of steroid which works by activating the oestrogen and progesterone receptors. It is a selective steroid that carries a slightly lower risk of breast cancer.

Is Elleste Solo bioidentical?

The oestrogen supplement in Solo is estradiol, which is bioidentical to the natural form of oestrogen which decreases with menopause.

Is oestrogen-only HRT safe for me?

Oestrogen-only HRT is only suitable for women who have had a hysterectomy or who have a Mirena coil in situ. Unopposed oestrogen leads to the lining of the womb (the endometrium) becoming thickened. This can lead to a condition called endometrial hyperplasia, and can also lead to endometrial cancer. The Mirena coil provides progestogen to the womb, which prevents this from happening.