Kliofem is an oral tablet that is taken daily to relieve menopause symptoms in postmenopausal women who still have a womb. It is a type of continuous combined hormone replacement therapy which means each tablet contains the same amount of the active ingredients, oestrogen and progesterone, and it is taken every day without a break.

Menopause symptoms can be debilitating and affect your quality of life. They are caused by a natural decline in oestrogen production by the ovaries. Kliofem tablets contain 2mg of estradiol and 1mg of norethisterone to restore hormonal balance and relieve symptoms, like hot flushes and night sweats.

The norethisterone in Kliofem is a type of progesterone which is important if you have not had your womb removed because oestrogen thickens the womb lining. So, progesterone limits overgrowth and lowers the risk of womb cancer.

Elleste Duet Conti is another example of a branded medication that contains 2mg of oestrogen and 1mg of progesterone, the same as Kliofem.

Kliofem works to relieve menopause symptoms by replacing the oestrogen that’s no longer produced by the body.

It contains 2 active ingredients, estradiol and norethisterone. Estradiol is a form of oestrogen that treats symptoms like hot flushes, night sweats, and irritability. Norethisterone is a synthetic progesterone that protects the womb lining from the effects of oestrogen, limiting overgrowth and reducing the risk of womb cancer.

The oestrogen in Kliofem also limits increased bone turnover and a reduction in bone mass, protecting against bone fractures and osteoporosis.

How long does Kliofem take to work?

Kliofem can relieve menopause symptoms within the first few weeks of treatment, but it can take up to 3 months to work fully.

How effective is Kliofem?

Kliofem effectively relieves menopause symptoms. Because it is a continuous combined HRT, it is designed not to cause a regular withdrawal bleed like cyclic or sequential HRT. Research shows that 94% of women do not experience bleeding or spotting during 10 to 12 months of treatment.

Kliofem also improved or maintained bone mineral density in 91% of women who were treated with Kliofem for 2 years. This is important for postmenopausal women as the risk of bone fractures and osteoporosis is higher when oestrogen levels drop.

Take 1 Kliofem tablet per day, around the same time, with a glass of water.

Once you have taken all 28 tablets (1 tablet per day for 28 days), start a new pack the next day without a break.

When to take Kliofem?

You can start Kliofem on any day that is convenient for you, unless you are switching from a method of HRT that causes a monthly bleed. In this case, you should start Kliofem as soon as the bleeding finishes.

You should take Kliofem at the same time each day. If you struggle to remember to take your pill, you could try using:

• a pill box
• a pill reminder app
• an alarm

What if I miss a dose of Kliofem?

If you miss a dose of Kliofem and it is:

• 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, skip the missed dose and 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 and you still have your womb.

Kliofem is a prescription-only medication, so it is not available over the counter, and you will need a prescription from a doctor to obtain it.

You can request Kliofem treatment online from a trusted online doctor or pharmacy service. Alternatively, it may be available on the NHS.

Can I buy Kliofem online?

Yes, you can request Kliofem 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 Kliofem over the counter?

No, Kliofem is not available without a prescription, so it cannot be bought over the counter.

Gina is an over-the-counter HRT treatment that is available online and from most UK pharmacies. It is a vaginal tablet that treats and relieves vaginal symptoms like dryness, soreness, itching, and irritation.

Can I get Kliofem on the NHS?

Yes, Kliofem 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:

• breast pain or tenderness
• vaginal bleeding

Common side effects include:

• vaginal fungal infection
• feeling sick (nausea)
• vaginal inflammation
• headache
• back pain
• leg cramps
• abdominal pain, swelling, or discomfort
• migraine that may be new or worse than before
• depression, new or worse than before
• uterine fibroids
• swollen arms or legs
• enlarged or swollen breasts
• weight gain
• weight gain from fluid retention

Uncommon side effects include:

• bloating or flatulence (gas)
• acne
• drug ineffective
• allergic reaction
• itching or hives
• hair loss
• abnormal male pattern hair growth
• nervousness
• inflammation of a vein

Rare side effects include:

• blood clots in the blood vessels of the legs or lungs

How long do Kliofem side effects last?

Most Kliofem side effects are temporary and will settle down or go away on their own, usually within 3 to 6 months as your body adjusts to the new medication. However, if you experience persistent or severe side effects, you should contact your doctor for advice.

What to do if you get Kliofem side effects

Most mild Kliofem 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:

• signs of an allergic reaction including hives, itching, swelling, breathing or swallowing difficulties, low blood pressure, dizziness, or sweating
• pain in your chest and breathlessness
• difficulty speaking or moving your arm or leg, or your face has dropped on one side

Do not take Kliofem if you:

• are allergic to any of the ingredients
• have a form of cancer that is sensitive to oestrogen, like womb cancer
• 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 Kliofem 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
• treatment for an underactive thyroid
• an inherited condition that causes recurrent episodes of swelling
• lactose intolerance

Kliofem and other medication

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

• epilepsy medications
• tuberculosis medications
• HIV medications
• hepatitis C 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 Kliofem.

What type of HRT is Kliofem?

Kliofem is a continuous combined HRT treatment which is taken every day without a break. Each tablet contains the same amount of oestrogen (estradiol) and norethisterone (progesterone).

Do you lose weight when taking Kliofem?

Weight loss whilst using Kliofem is listed as a very rare side effect. However, weight fluctuations during menopause are common. There is currently no clinical evidence that Kliofem causes weight gain or loss.

Can you take Kliofem long-term?

Kliofem is usually taken for 2 to 5 years to treat menopause symptoms, but it can be taken for longer if required. Your doctor will assess you before you start taking Kliofem and will prescribe the lowest dose required to treat your symptoms. Once you begin your treatment, your doctor will monitor your medication at least once a year to check you still require the dosage you are taking and that it is still working for you.

Does Kliofem stop your periods?

Kliofem is usually prescribed to women who are postmenopausal and have not had a period for at least a year. Unlike sequential HRT, continuous combined HRT, like Kliofem, does not cause a monthly bleed.

What happens if you stop taking Kliofem suddenly?

If you stop taking Kliofem suddenly, your menopause symptoms may return. You should talk to your doctor if you are thinking about stopping Kliofem as they may suggest cutting your dose gradually to stop your symptoms from returning.

Is Kliofem the same as Kliovance?

No, Kliofem and Kliovance share the same ingredients, estradiol and norethisterone, but Kliovance contains half the amount of active ingredients as Kliofem. If Kliovance has not been effective for you, your doctor may prescribe Kliofem instead.