Elleste Solo

Elleste is a hormone replacement therapy (HRT) to help with the symptoms of menopause. It contains the hormone oestrogen (estradiol). Menopause causes the level of oestrogen in the blood to drop when the ovaries are no longer producing eggs. This can lead to unpleasant side effects such as night sweats, mood swings, vaginal dryness and hot flushes. When these symptoms are moderate, many women find that they can cope via a few lifestyle changes, but in others, they are severe and disrupt daily life. Elleste Solo has been developed to replace the oestrogen and get women back to leading a normal, active life. Elleste Solo is an oestrogen-only HRT.

During childbearing years, menstruation can cause pre-menstrual tension, cramps and bloating. When these are over, the symptoms may change to those of the menopause. This usually begins between the ages of 45 and 55, with the average age in the UK being 51, when the body runs out of eggs from the ovaries.

There are three stages of menopause:

1. Peri-menopause:
   When periods become less frequent and lighter, lasting on average four years.
2. Menopause:
   Once the last period finishes – the average age in the UK is 51.
3. Post-menopause:
   Menopause ends one full year after the last period but usually takes two to five years for symptoms to stop.

Menopause is a gradual process and can take anything from six months to 13 years to fully run its course. As the ovaries stop producing eggs, they also cease production of the hormone oestrogen, which lowers the levels of this hormone in the blood. Low levels of oestrogen are responsible for many of the unpleasant symptoms of menopause, such as:

• Hot flushes;
• Vaginal dryness;
• Lower sex drive;
• Night sweats;
• Difficulty sleeping;
• Headaches;
• Anxiety;
• Mood changes;
• Palpitations;
• Joint pain or stiffness;
• Frequent urinary tract infections;
• Reduced muscle mass.

Low levels of oestrogen can also leave women susceptible to diseases such as osteoporosis, as the bones can become fragile. There are certain lifestyle changes that can help to ease some of the symptoms of menopause:

• Maintaining a healthy lifestyle;
• Eating a well-balanced diet with plenty of nutrients;
• Exercising for 30 minutes a day at least five times a week;
• Limiting alcohol intake;
• Losing any excess weight.

The suggestions above can help ease sleep problems and improve moods as well as generally giving women more energy and zest for life. The following may help with hot flushes:

• Dress in comfortable, layered clothing and remove a layer if you become too hot;
• Avoid caffeine, alcohol and spicy foods as these can be triggers;
• Take cool showers;
• Open windows and allow air to circulate.

Some women use complementary or herbal medicines as a way to help alleviate the symptoms, but it is unclear how effective or safe these are, as they are not regulated in the same way as conventional medicines.

Although tips for coping can be helpful, there are times when they are simply not sufficient and menopausal symptoms get in the way of living life to the full. If that is the case, you may want to consider seeking medical assistance. The main medicine available in the UK for relieving menopausal symptoms is HRT. As the name suggests, the treatment contains the female hormone oestrogen or a combination of oestrogen and progesterone in an attempt to re-balance the body’s supply and restore the levels of these hormones in the blood. Not all HRT treatments are taken the same way: some are taken continuously, while others alter along with the menstrual cycle. It is often a case of trial and error to find the right treatment – either single or combined hormones. It will also depend on which of the symptoms are affecting your life the most. You should always start with the lowest dose and increase if necessary.

You should also note that if you are taking an oestrogen preparation, it is important to take progesterone to protect the uterus from uterine cancer (if you have not had a hysterectomy). There are also different ways of getting the hormones into your bloodstream, namely tablets, patches, vaginal creams, gels, pessaries and rings.

Elleste Solo is one of these treatments and comes as both a tablet and a transdermal patch. The following information will help you judge whether this treatment would suit you.

Elleste is an HRT to help with the symptoms of menopause. It contains the hormone oestrogen (estradiol). Menopause causes the level of oestrogen in the blood to drop when the ovaries are no longer producing eggs. This can lead to unpleasant side effects such as night sweats, mood swings, vaginal dryness and hot flushes. When these symptoms are moderate, many women find that they can cope via a few lifestyle changes, but in others, they are severe and disrupt daily life. Elleste Solo has been developed to replace the oestrogen and get women back to leading a normal, active life. Elleste Solo is an oestrogen-only HRT.

Elleste Solo is used to relieve the symptoms that occur after the menopause, such as hot flushes. It is only prescribed if these symptoms seriously limit daily life. Elleste Solo can also be used in higher doses to prevent the onset of osteoporosis where other medicines are not suitable.

When taking any prescribed medication, always follow the instructions given to you by your doctor. Elleste Solo comes both as a patch and as a tablet.

For the tablet:

• Start on the first day you start bleeding on a new cycle if you are still having periods;
• Start straight away if you are no longer having periods;
• Swallow the tablet whole with water around the same time every day.

For the patch:

• Start within five days of starting your period if you are still having them;
• Start straight away if you are no longer having periods.

Application:

• Ensure the skin where you are placing the patch is clean, dry, unbroken and free from any rashes or irritation;
• Remove the patch from its sealed sachet;
• Take off the small piece of shiny backing, followed by the larger one;
• Place the patch below the waistline, e.g. lower back or buttock;
• Press firmly for 10-20 seconds;
• Change your patch twice a week;
• When correctly applied, the patch should stay in place whilst swimming, running, bathing etc.

Both Elleste Solo patches and tablets come in two different strengths. The patches come in 40 mcg and 80 mcg doses, while the tablets come in 1mg and 2mg doses.

Tablet

You should always be prescribed the lowest possible dose for the shortest possible time required. The larger doses are usually aimed at preventing osteoporosis rather than regulating menopausal symptoms. Take one Elleste Solo tablet (whichever strength you are prescribed) once a day with a glass of water. Aim to take it at the same time every day. The pack is marked with arrows to show you which Elleste Solo tablet to take next, and the days of the week are also marked to help you remember to take one each day.

If you forget to take your Elleste Solo tablet at the usual time, take it as soon as you remember, unless you are more than 12 hours late, in which case simply skip this dose – do not take a double dose. Skipping a dose may cause breakthrough bleeding if you have not had a hysterectomy. If you take too many Elleste Solo tablets, it is unlikely to cause serious harm, but you may feel or be sick, feel drowsy or experience some bleeding.

Patch

No matter which strength patch you are using, the standard dose is one patch twice a week. Change your Elleste Solo patch on the same two days each week, e.g. Monday and Thursday. This will help you remember to do so. If for any reason your patch becomes unstuck before it is due to be changed, change it anyway and then change it again on the usual day. If you use the Elleste Solo patches properly, it is virtually impossible to overdose on estradiol, but if you are worried, please seek medical assistance.

As with all medicines, Elleste Solo comes with some side effects, although not everyone using it will experience them. There are more reported cases of the following in women using HRT than those who do not:

• Breast cancer;
• Cancer of the lining of the womb;
• Blood clots in the legs veins or lungs;
• Heart disease;
• Stroke;
• Memory loss.

If you experience any of the following, stop using Elleste Solo and contact your doctor immediately:

• Jaundice (yellowing of the skin and the white of the eyes);
• A new migraine;
• Unexplained epileptic fit;
• Painful swelling in your leg, sudden chest pain or difficulty breathing – these may be signs of a blood clot;
• Fainting or collapsing;
• Loss of vision/partial vision;
• Hearing problems.

Common side effects, affecting up to 1 in 10 people are:

• Headaches;
• Nausea;
• Breakthrough bleeding;
• Irregular cycles;
• Changes in weight;
• Oedema (fluid retention);
• Breast tenderness or swelling;
• Mood swings;
• Changes in sex drive;
• Rashes or itching.

If you have or have ever had any of the following you should not take Elleste Solo:

• Breast cancer;
• Cancer of the lining of the womb;
• Unexplained vaginal bleeding;
• Excessive thickening of the lining of the womb;
• Blood clots in a vein;
• Heart attack, stroke or angina;
• Liver disease;
• Blood clotting disorders.

If you are allergic to estradiol or any of the other ingredients listed on the pack, you should avoid using Elleste Solo tablets or patches. If you have or have ever had any of the following, you should take extra precautions and have regular check- ups whilst taking Elleste Solo as it can worsen these conditions:

• Fibroids;
• Diabetes;
• High blood pressure;
• Gallstones;
• Epilepsy;
• Asthma;
• Migraines;
• Diseases of the immune system;
• Otosclerosis (a hearing problem);
• Fluid retention due to cardiac or kidney issues;
• Increased risk of developing blood clots or an oestrogen-sensitive cancer (breast, womb etc.);
• A history of excessive thickening of the lining of the womb.

Some medicines may interfere with Elleste Solo and can cause irregular bleeding. These medicines are:

• Medicines for epilepsy;
• Medicines for tuberculosis;
• Drugs that prevent harmful blood clots;
• Medicines that treat Parkinson’s disease;
• Medicines for HIV infection;
• Sedatives;
• Herbal remedies containing St John’s Wort.

You can buy Elleste Solo tablets and patches from pharmacies nationwide. You can order them discreetly from an online pharmacy and have them delivered to your door, or simply pick them up at your local pharmacy.

No, you will need a prescription to buy Elleste Solo tablets or patches. You can talk to your usual doctor or organise an online consultation if you find that easier.

Brazier, Yvette. (May 2017). What you need to know about HRT. Retrieved from https://www.medicalnewstoday.com/articles/181726.php

Irani, Shirin. (2019). Consultant Gynaecologist Menopause. Retrieved from https://www.bupa.co.uk/health- information/womens- health/menopause

Mylan Products Ltd. (May 2018). Elleste Solo tablets MX Patient Leaflet. Retrieved from https://www.medicines.org.uk/emc/files/pil.6351.pdf

NHS UK. (July 2016). Hormone Replacement Therapy. Retrieved from https://www.nhs.uk/conditions/hormone- replacement- therapy- hrt/

NHS UK. (August 2018). Menopause Treatment. Retrieved from https://www.nhs.uk/conditions/menopause/treatment/

Piramal Healthcare UK. (December 2018). Ltd Elleste Solo tablets Patient Leaflet. Retrieved from https://www.medicines.org.uk/emc/files/pil.9512.pdf