Femoston
How does it work?
This medicine contains two active ingredients, estradiol hemihydrate (previously spelt oestradiol hemihydrate in the UK) and dydrogesterone. These are forms of the main female --- hormones, oestrogen and progesterone. Estradiol hemihydrate is a naturally occuring form of oestrogen and dydrogesterone is a synthetic form of progesterone. Womens' ovaries gradually produce less and less oestrogen in the period up to the menopause, and oestrogen blood levels decline as a result. The declining levels of oestrogen can cause distressing symptoms, such as irregular periods, hot flushes, night sweats, mood swings and vaginal dryness or itching. Oestrogen (in this case in the form of estradiol hemihydrate) can be given as a supplement to replace the falling levels in the body and help reduce these distressing symptoms of the menopause. This is known as hormone replacement therapy (HRT). HRT is usually only required for short-term relief from menopausal symptoms and its use should be reviewed at least once a year with your doctor. The declining level of oestrogen at menopause can also affect the bones, causing them to become thinner and more prone to breaking; a condition known as osteoporosis. Oestrogen can therefore also be supplemented to help prevent bone loss and fractures that may occur in women in the years after menopause. However, in December 2003, a review of the available evidence on the risks and benefits of HRT by the Medicines and Healthcare products Regulatory Agency (MHRA) and the Committee on Safety of Medicines (CSM) in the UK, concluded that the risks of using HRT long-term to prevent osteoporosis in women aged over 50 years exceed the benefits. As a result this medicine should not be used as a first-line option for preventing postmenopausal osteoporosis in women over 50. However, it may be used as a second-line option for women at high risk of fractures who cannot take other medicines that are licensed for preventing osteoporosis. Women considered to be at risk of developing fractures following the menopause include those who have had an early menopause, those with a family history of osteoporosis, those who have had recent prolonged corticosteroid therapy (eg prednisolone), those with a small thin frame, and smokers. You can read more about the risks and benefits of HRT and other medicines for preventing osteoporosis in the factsheets about menopause and osteoporosis linked below. A progestogen (in this case in the form of dydrogesterone) is needed as part of HRT for women who have not had a hysterectomy. This is because in women with an intact womb, oestrogen stimulates the growth of the womb lining (endometrium), which can lead to endometrial cancer if the growth is unopposed. A progestogen is given to oppose oestrogen's effect on the womb lining and reduce the risk of cancer, though it does not eliminate this risk entirely. This is known as combined HRT. Femoston is a sequential form of combined HRT. This means that oestrogen is taken on a continuous basis and progesterone is added for the last two weeks of each month. The tablets taken in the first two weeks of each Femoston cycle contain only estradiol hemihydrate, while the tablets taken in the second two weeks of each cycle contain both estradiol and dydrogesterone. This type of HRT is more suitable for women who are still having irregular periods, because it usually results in a monthly period towards the end of taking the dydrogesterone. Femoston-conti is a continuous form of combined HRT. This means that each tablet contains both estradiol hemihydrate and dydrogesterone, so that a dose of both hormones is taken daily. This type of HRT does not produce a monthly period, and so is more suitable for women whose periods have already stopped, ie for postmenopausal women.