Elleste Duet Conti is a type of continuous, combined hormone replacement therapy (HRT) and is only available on prescription. It’s taken every day, without a break between packs. Elleste Duet Conti contains 2 active ingredients, oestrogen (estradiol) and progesterone (norethisterone acetate) and is suitable if you are postmenopausal and have not had a period for at least 12 months.

Menopause symptoms are caused by a drop in oestrogen and progesterone production by the ovaries. Elleste Duet Conti increases these hormone levels to effectively relieve symptoms, including:

• hot flushes
• night sweats
• mood swings
• vaginal dryness and irritation

If you have not had your womb removed (hysterectomy), it is important to use combined HRT because oestrogen alone thickens the womb lining and slightly increases the risk of womb cancer. So, taking progesterone also protects the womb lining, stopping it from becoming too thick.

Elleste Duet Conti tablets are a brand name for combined HRT tablets containing 2mg of oestrogen and 1mg of progesterone. Kliofem is an alternative branded version of this type of HRT.

Elleste Duet Conti works by replacing the declining oestrogen and progesterone levels caused by menopause. It contains synthetic versions of these hormones which are:

• estradiol – replaces the lost oestrogen levels in the body to relieve symptoms like hot flushes, night sweats, vaginal dryness, and low mood
• norethisterone – a type of progesterone that protects the womb lining from the effects of oestrogen, preventing overgrowth and cancer

Because Elleste Duet Conti is a continuous combined HRT, it is taken daily without a break. This maintains a stable hormonal environment, providing effective symptom relief and preventing irregular bleeding, making it a suitable medication for postmenopausal women who have not had a period for at least 12 months.

How long does Elleste Duet Conti take to work?

It can take up to 3 months for Elleste Duet Conti to work fully to improve your symptoms.

How effective is Elleste Duet Conti?

Elleste Duet Conti is an effective combined HRT method with studies showing it effectively relieves menopause symptoms and reduces:

• bone loss markers by 66% – women who have gone through the menopause are more likely to get osteoporosis, a condition that weakens bones
• total cholesterol by 12% and low-density lipoprotein (LDL) or ‘bad cholesterol’ by 13% – cholesterol can increase after menopause causing further health problems

Elleste Duet Conti tablets are taken every day without a break. They should be swallowed whole with a glass of water if needed.

To take Elleste Duet Conti you should:

• take a pill marked with the correct day of the week
• follow the direction of the arrows printed on the pack, taking 1 pill every day until the pack is empty
• when you finish a strip, start a new strip the next day

If you are struggling to remember to take your pill, you can use any of the following to remind you:

• a pill box marked with the days of the week
• an alarm on your phone set to the time you normally take your tablet
• a pill reminder app

What if I miss a dose of Elleste Duet Conti?

If you forget to take an Elleste Duet Conti pill and it has been:

• less than 12 hours since the missed dose, take it as soon as you remember, then take your next pill at the correct time as usual
• more than 12 hours since the missed dose, take the next one at the normal time

Do not take a double dose to make up for a missed dose. You may experience some breakthrough bleeding or spotting if you are late or miss a dose.

You can request Elleste Duet Conti treatment online from a reputable online doctor or pharmacy service. Alternatively, it may be available on the NHS, depending on your suitability and its availability.

Elleste Duet Conti is a prescription-only medication, so you must have a doctor’s approval to obtain it and cannot be bought over the counter.

Can I buy Elleste Duet Conti online?

Yes, you can request Elleste Duet Conti online at Superdrug Online Doctor by:

1. Filling out a brief health and lifestyle questionnaire.
2. Ordering your preferred treatment and making payment.
3. One of our doctors will review your order and questionnaire answers.
4. If approved, your treatment will be posted to your address or made available for collection at your local Superdrug Pharmacy.
5. If your order is not approved, one of our doctors will contact you via your account with other treatment options.

Can I buy Elleste Duet Conti over the counter?

No, Elleste Duet Conti is a prescription-only medication, so you will need a prescription before you can obtain it.

If you are looking for an over-the-counter form of HRT, Gina is available online and from most UK pharmacies.

Can I get Elleste Duet Conti on the NHS?

Yes, Elleste Duet Conti is a type of hormone replacement therapy that is available on the NHS. However, you will need to make an appointment with your doctor to see if it is suitable for you.

Very common side effects include:

• headache
• breast pain or tenderness
• painful periods
• menstrual cycle issues

Common side effects include:

• feeling anxious
• feeling down
• mood changes
• changes in sex drive
• acne
• vaginal discharge
• spasms or contractions in the womb
• feeling dizzy
• dry skin
• itchiness
• increase in weight
• swelling of the hands or fingers
• back pain
• pain in the extremities
• difficulty in sleeping
• feeling sick
• bloating
• indigestion
• stomach cramps
• rashes
• enlarged breasts
• thickening of the lining of the womb
• heavy periods
• feeling weak
• swollen ankles, feet or fingers
• heavy periods

Uncommon side effects include:

• migraine
• a feeling of dizziness or “spinning”
• high blood pressure
• varicose veins
• being sick
• gallstones and gallbladder disease
• change in colour of the skin
• muscle cramps
• breast cancer
• increased levels of chemicals in the blood, which may indicate disease

Rare side effects include:

• tingling or numbness
• blood clot in a vein
• inflammation of a vein
• hypersensitivity
• muscle weakness
• growths in the womb

A full list of side effects can be found in the patient information leaflet that comes with the medication. Even though Elleste Duet Conti can cause side effects, it doesn’t mean everyone will get them.

How long do Elleste Duet Conti side effects last?

Side effects caused by Elleste Duet Conti usually last a few weeks to a few months until your body has got used to the medication. However, if you experience persistent or severe side effects, you should contact your doctor for advice.

What to do if you get Elleste Duet Conti side effects

Most mild Elleste Duet Conti side effects can be managed at home. Some of the things you can do to help include:

• take over the counter painkillers, like paracetamol or ibuprofen, for side effects like headaches, stomach cramps, or breast pain
• take your pill with food if you feel sick and stick to eating simple foods until your body gets used to the medication
• drink plenty of fluids to help keep you hydrated, especially if you are sick or have headaches
• use a warm compress to help manage stomach cramps

If you experience any of the following serious side effects, you should call 999 or get someone to take you to A&E straight away:

• pain in your chest and breathlessness
• difficulty speaking or moving your arm or leg, or your face has dropped on one side
• signs of an allergic reaction, such as difficulty breathing, swelling of the face and throat, rash, and fainting

Do not take Elleste Duet Conti if you:

• are allergic to any of its ingredients
• have a form of cancer that is sensitive to oestrogen
• have or think you may have breast cancer
• have endometrial hyperplasia, an excess thickening of the lining of the womb that you are not receiving treatment for
• have or have ever had a blood clot in a vein
• have or have recently had heart attack, stroke, or angina
• experience unexplained vaginal bleeding
• have or have ever had liver disease
• have a hereditary blood condition known as porphyria
• have a blood clotting disorder

You should speak to your doctor before taking Elleste Duet Conti if you have or have ever had any of the following:

• epilepsy
• asthma
• fibroids inside your womb
• an increased risk of developing blood clots
• high blood pressure
• gallstones
• migraines or severe headaches
• a disease of the immune system
• hereditary or acquired angioedema
• high levels of fat in your blood
• a disease that affects your hearing or the eardrum
• kidney or cardiac problems that cause fluid retention
• a liver disorder
• an oestrogen-sensitive cancer

Elleste Duet Conti and other medication

Some medications can interfere with the effectiveness of Elleste Duet Conti. Tell your doctor if you are taking:

• epilepsy medications
• tuberculosis medications
• HIV medications
• St John’s wort

Let your doctor know if you are or are going to take any prescription, over-the-counter, or herbal medications before taking Elleste Duet Conti.

HRT and blood clots

While taking Elleste Duet Conti, the risk of blood clots in a vein is 1.3 to 3 times higher than in non-users, especially during the first year of treatment. Blood clots can be serious, especially if it travels to your lungs.

You’re more likely to get a blood clot in your veins as you get older. You must let your doctor know if any of the following applies to you:

• you are unable to walk for a long time because of major surgery, injury or illness
• you are seriously overweight (BMI over 30)
• you have a blood clotting problem that needs long-term treatment with a medicine
• any of your close relatives have ever had a blood clot
• you have systemic lupus erythematosus (SLE)
• you have cancer

Signs of a blood clot include:

• painful swelling and redness of the legs
• sudden chest pain
• difficulty in breathing

You must call 999 straight away or get someone to take you to A&E if you think you have a blood clot.

HRT and cancer

Taking HRT like Elleste Duet Conti has been associated with a slightly higher risk in some forms of cancers, such as breast and ovarian cancer. The extra risk depends on how long you use it and usually becomes clear within 3 years of use. After stopping HRT the extra risk will decrease with time, but may persist for 10 years or more if you use HRT for more than 5 years.

Breast cancer

For women aged 50 who start taking oestrogen-progestogen HRT for 5 years, there will be 21 breast cancer cases in 1000 users compared to 13 to 17 in those not taking HRT. Regularly check your breasts, attend your mammogram appointments, and see your doctor if you notice any changes such as:

• dimpling of the skin
• changes in the nipple
• any lumps you can see or feel

Ovarian cancer

Ovarian cancer is very rare. For example, about 2 in 2000 non-HRT users will be diagnosed with ovarian cancer over 5 years. In women taking HRT for 5 years, there will be about 3 cases per 2000, meaning there is, on average, 1 extra case per year.

Let your doctor know straight away if you notice any of the following while taking HRT:

• a swollen or bloated stomach
• pain or tenderness in your stomach or pelvis
• reduced or no appetite
• feeling full quickly after eating
• an increased need or urgency to pee

Other cancers

The progestogen in Elleste Duet Conti Tablets protects you from the risk of endometrial cancer caused by the thickening of the lining of the womb.

More information on this can be found in the patient information leaflet.

What is the difference between Elleste Duet and Elleste Duet Conti?

Elleste Duet is a cyclical HRT that is taken in phases. It is available in 1mg or 2mg doses. The first 16 tablets contain estradiol while the last 12 tablets contain a combination of estradiol and norethisterone which results in a period-like bleed.

Elleste Duet Conti is a combined continuous HRT that contains both estradiol and norethisterone in a continuous dose. You take one tablet every day without a break between packs.

Can Elleste Duet Conti cause bleeding?

Elleste Duet Conti doesn’t normally cause a monthly bleed but when you first start taking it, you may experience irregular spotting or bleeding. This should settle down as your body adjusts to the medication. However, if you are still experiencing spotting or bleeding after six months you should contact your doctor.

Can I drink alcohol with Elleste Duet Conti?

Yes, you can drink alcohol while taking Elleste Duet Conti, but it may increase your chances of experiencing side effects.

Will Elleste Duet Conti affect my mood?

Yes, one of the possible side effects of Elleste Duet Conti is changes to your mood, including feelings of anxiety and depression. However, not everyone will experience mood changes, but if you do, it is important to let your doctor know.

Does Elleste Duet Conti make you feel tired?

Yes, Elleste Duet Conti and other types of combined HRT can make you feel tired because of the progesterone they contain. This may improve as your body adjusts to the treatment and within the first 3 months, but if it persists or is affecting your life, let your doctor know.