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Elleste Duet

Elleste Duet

Elleste Duet is a form of sequential Hormone Replacement Therapy, it contains two types of the female hormone, estradiol and norethisterone. These replace the hormones progesterone and oestrogen in your body. A sequential HRT means you will still have a monthly bleed. 

Menopause may be the source of many jokes, but it’s also a real problem that can drastically interfere with your daily life. It usually starts sometime between the ages of 45 and 55, though can happen earlier or later. It’s your body’s way of saying your childbearing years are over. Menopause starts because your ovaries stop producing eggs. It’s not an overnight process and can take anywhere from 6 months to 13 years.  

When your ovaries stop producing eggs the levels of the hormone progesterone in your body start to fall and the lower level of this hormone can cause some unpleasant symptoms. Different symptoms can affect different women at different times, although some are more common in the earlier stages, like hot flushes, and others are more common in the later stages like vaginal dryness.

Other symptoms you may experience are: 

  • Difficulty sleeping 
  • Lower sex drive 
  • Reduced muscle mass 
  • Anxiety 
  • Night sweats 
  • Mood changes 
  • Palpitations 
  • Frequent urinary tract infections 
  • Headaches 
  • Joint pain or stiffness 
  • Weak bones or osteoporosis 

Symptoms can often be mild meaning they don’t cause too much of a disturbance to your life, but sometimes they are more severe. There are many little changes you can make to help your body cope with the symptoms of the menopause. Sometimes simple changes can have a big difference in your ability to cope. 

Maintaining good health and fitness during the menopause one really important factor that can help limit these symptoms and to protect yourself as much as possible from any related diseases like osteoporosis. Staying fit and active, eating a well- balanced, healthy diet, getting rid of excess weight, limiting your alcohol intake and quitting smoking are all good tips. Aim to exercise 5 times a week for at least 30 minutes at a time to help with sleep issues and low moods. Get plenty of fresh air too as this will also help you sleep. Doing pelvic floor can help to strengthen the muscles around the bladder and ward off problems in this area. 

One of the most common and annoying symptoms of menopause is hot flushes, for some they are mild, for others moderate or severe. There is always something you can do to help.

Try the following:

  • Dress in layers so you can remove a layer when you are feeling hot 
  • Avoid spicy foods
  • Take cool showers 
  • Avoid caffeine and alcohol 

If you find simple lifestyle changes aren’t helping with the symptoms of menopause and they are making your life miserable or indeed interfering with your ability to lead a normal life then you may wish to seek medical help. As mentioned, the process can be a long one, so you don’t want to suffer unnecessarily for years. Some women turn to complementary medicine and therapies, but you should do this with caution as they aren’t tested or regulated in the same way as traditional medicines. 

The main type of medical treatment for menopause in the UK is Hormone Replacement Therapy (HRT). Hormone Replacement Therapy comes in different shapes and sizes, you can take a combination of oestrogen and progesterone or just oestrogen. Getting the right type for you can be a process of trial and error. 

Hormone Replacement Therapy can also be taken or applied in different ways; vaginal creams, gels, tablets, patches, rings and pessaries are all available for different issues. Elleste Duet is one type of medication you may wish to try, particularly if you are struggling with hot flushes. Read on to find out more. 

What is Elleste Duet? 

Elleste Duet is a form of sequential Hormone Replacement Therapy, it contains two types of the female hormone, estradiol and norethisterone. These replace the hormones progesterone and oestrogen in your body. A sequential HRT means you will still have a monthly bleed. 

When is Elleste Duet used? 

Elleste Duet is used to prevent the symptoms of menopause, in particular, hot flushes and can also be used after the menopause to help ward off the onset of osteoporosis. These symptoms are caused when the levels of oestrogen in your body fall as your ovaries stop producing eggs. 

You will only be prescribed Elleste Duet if your symptoms are seriously affecting your ability to lead a normal daily life. 

How do you use Elleste Duet? 

Always follow the instruction of your doctor or pharmacist when it comes to taking medication.  Each pack of Elleste Duet will contain pills in two different colours, 16 either white or orange tablets and 12 pale green or grey. You start with white or orange tablets. You should take all of the first colour before moving on to the second.  

The first pill, with 16 tablets, contains only estradiol, the 12 tablets contain both estradiol and norethisterone.  If you are still having regular periods start taking the tablets on the first day of bleeding. If you are not having regular periods you can start whenever you want to. If you are switching from another HRT you can start as soon as you finish your current course of treatment. 

You will normally have a period at some point between day 21 of the packet and day 5 on the next, it should be regular each month. Some women will not have a period while taking Elleste Duet. Take one tablet a day. Swallow the tablet whole with water. 

Each pack has arrows showing which tablet to take next and comes with a day of the week sticker so that when you come to the end of the pack you know what day to start a new pack. If you forget to take your tablet then take it as soon as you remember, if you are more than 12 hours late do not take the tablet, simply dispose of it safely and carry on with the next tablet as normal. Never take a double dose to make up for a missed dose. If you accidentally take more Elleste Duet than you should you may feel sick or be sick, feel tired or depressed. This should pass but if you are worried contact your doctor. 

What dosages are there? 

Elleste duet comes in two different doses: 

  • 1mg (white tablet contains 1mg of estradiol and pale green tablet contains 1mg each of estradiol and norethisterone) 
  • 2mg (orange tablet contains 2mg of estradiol and grey tablet contains 2mg each of estradiol and norethisterone) 

Each pack contains 16 tablets in one colour and 12 in another. You take one tablet per day. You take the tablets continuously with no break. 

What are the side effects of Elleste Duet? 

As with all medicines, Elleste Duet can cause side effects although not everyone will get them. There are some diseases that are reported more often in women using HRT compared to women who aren’t using HRT.

These include: 

  • Blood clots in the leg veins or lungs 
  • Memory loss (dementia) 
  • Ovarian cancer 
  • Heart disease 
  • Abnormal growth or cancer of the lining of the womb 
  • Stroke 
  • Breast cancer 

Very common side effects that may affect more than 1 in 10 people include: 

  • Breast pain 
  • Headache 
  • Problems with the menstrual cycle 
  • Painful periods 

Common side effects that may affect up to 1 in 10 people include: 

  • Anxiety 
  • Nausea 
  • Indigestion 
  • Back pain 
  • Bloating 
  • Low mood 
  • Itchiness 
  • Diarrhoea 
  • Weight increase 
  • Vaginal discharge 
  • Break-through bleeding 
  • Vaginal infection 
  • Cramps 
  • Acne 
  • Mood swings 
  • Swollen ankles, feet or fingers 
  • Rashes 
  • Dry skin 
  • Excessive thickening of the womb lining 

Uncommon side effects that may affect up to 1 in 100 people include: 

  • Gallstones and gallbladder disease 
  • Dizziness 
  • Muscle cramps 
  • High blood pressure 
  • Varicose veins 
  • Vomiting 
  • Migraine 
  • Breast cancer 

Rare side effects that may affect up to 1 in 1,000 people are: 

  • Hypersensitivity 
  • Tingling or numbness 
  • Muscle weakness 
  • Blood clot in a vein 
  • Vein inflammation 
  • Growths in the womb 

When shouldn’t you use Elleste Duet? 

Do not take Elleste Duet if any of the following apply to you: 

  • You have a blood clotting disorder
  • You have ever had breast cancer or cancer of the lining of the womb 
  • You have angina
  • You’ve had a stroke
  • You have or have had liver disease
  • You’ve ever had blood clots on the leg veins or lungs
  • You have excessive thickening of the womb lining
  • You have unexplained vaginal bleeding

If any of the conditions listed above appear for the first time when taking Elleste Duet then stop taking it immediately and consult your doctor. There are also some problems or illnesses that may return or worsen while you are taking Elleste Duet, so you will need to see your doctor more often for check-ups if any of the following apply to you: 

  • Gallbladder disease 
  • Severe headaches 
  • High levels of fat in your blood 
  • Epilepsy 
  • Growth of womb lining outside your womb or excessive growth in the womb lining 
  • High blood pressure 
  • Kidney disease 
  • Fibroids 
  • Fluid retention 
  • Asthma 
  • A disease which affects your immune system 

If you experience any of the following while taking Elleste Duet, stop taking it and consult a doctor immediately: 

  • Jaundice (yellowing skin) 
  • Migraines for the first time 
  • Signs of a blood clot (swelling/redness in the legs) 
  • Sudden chest pain 
  • Breathing difficulties 
  • You become pregnant 

Does Elleste Duet interact with other medications? 

Always discuss any other medication you are taking with your doctor, including herbal medicines or supplements as some of these may prevent Elleste Duet from working effectively or vice versa. 

It is particularly important you mention any of the following: 

  • Anti-infective (used to treat tuberculosis) 
  • Medicines for HIV infection 
  • Anticonvulsants (used for epilepsy) 
  • St. John’s wort or other similar herbal remedies 

Where can you buy Elleste Duet? 

You can buy Elleste Duet from pharmacies nationwide; you can order online or pick up in your local pharmacy. 

Can I get Elleste Duet without a prescription? 

Elleste Duet is a prescription only medication, you will need a consultation with a doctor in order to get a prescription for it. This could be your family doctor or any other doctor who will go through a checklist with you to make sure the drug is the right choice for you and your symptoms and ensure that there is nothing in your medical history to prevent you from taking the drug. You cannot buy Elleste Duet over the counter without a prescription. 




Irani, Shirin Consultant Gynaecologist Menopause (2019) Retrieved from Menopause symptoms (March 2019) Retrieved from 

NHS UK Hormone Replacement Therapy (July 2016) Retrieved from 

NHS UK Menopause Treatment (August 2018) Retrieved from 

Piramal Healthcare UK Ltd Elleste Duet Patient Leaflet (May 2018) Retrieved from