Oestrogène et progestatif combinés pour THS

About combined HRT

Most hormone replacement therapy (HRT) is a combination of two female hormones, an 'oestrogen' and a 'progestogen'. Oestrogens and progestogens are natural female hormones which are used to treat women's health problems, including menopausal symptoms. Different types of oestrogen and progestogen are used in HRT products.

The oestrogens used include conjugated oestrogens, estradiol, estriol and estrone. The progestogens used include progesterone, medroxyprogesterone, norgestrel, drospirenone, norethisterone, dydrogesterone, and levonorgestrel. You will find the names of the oestrogen and progestogen used in your HRT on the labelling of the package. HRT is available as tablets and as patches to be applied to your skin. There are several brands for each of these types of HRT - all deliver a set dose of oestrogen and progestogen into your bloodstream.

If you have had your uterus removed during surgery (a hysterectomy), then you will only need to take oestrogen HRT. Please see the separate leaflet called THS œstrogène pour plus d'informations à ce sujet.

During the ménopause, or 'change', your natural female hormone levels begin to fall. HRT replaces these hormones. The oestrogen helps to relieve some of the problems associated with the menopause, such as hot flushes, night sweats and vaginal dryness. The progestogen protects the lining of your womb (uterus). Depending on the preparation you are using, you may take the progestogen daily or for only part of the month.

HRT also protects against ostéoporose, although other treatments are often preferred for this. Osteoporosis weakens your bones, making breaks and fractures more likely.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking HRT it is important that your doctor knows:

• Si vous avez des maux de tête semblables à des migraines.

• Si vous avez des saignements vaginaux inexpliqués.

• Si vous avez eu un cancer du sein ou des nodules dans votre sein, ou si un membre proche de votre famille a eu un cancer du sein.

• Si vous ou un membre proche de votre famille avez déjà eu un caillot sanguin dans les jambes ou les poumons.

• If you have a problem with your veins (such as thrombophlebitis).

• If you have too much sugar in your blood (diabetes mellitus), epilepsy, or asthma.

• If you have liver, kidney, or gallbladder problems.

• If you have ever had depression.

• If you have high blood pressure or a heart disorder.

• If you have chest pain (angina) or if you have had a heart attack.

• If during a pregnancy you have had problems such as severe itching and blistering of your skin, yellowing of your skin or the whites of your eyes (jaundice), or any involuntary jerky movements.

• If you have a rare inherited blood disorder known as porphyria.

• Si vous avez déjà eu une réaction allergique à un médicament.

• Si vous prenez ou utilisez d'autres médicaments. Cela inclut tous les médicaments que vous prenez et qui sont disponibles à l'achat sans ordonnance, ainsi que les médicaments à base de plantes et complémentaires.

• Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about the specific brand of HRT you have been given, and a full list of possible side-effects from taking it.

• If you have been prescribed tablets or capsules: follow the instructions on your pack - it is usual to take one dose every day:

  • Some brands may have different coloured tablets to take on certain days; other brands may contain a second tablet for you to take on certain days of the month. If you are unsure what to do, ask your pharmacist for advice.

  • Take the dose at the same time of day each day. If you forget to take a dose, read the advice on the manufacturer's leaflet and follow the instructions it gives. You can take the tablets before, during or after your meals.

• Si des patchs vous ont été prescrits: some patches are applied and left on for a whole week (such as FemSeven®), whereas with others you apply two patches during a week (each is removed after 3-4 days). Make sure you are clear about how often to use the patches you have been prescribed - the instructions for how to use them will be on the label of the pack:

  • Apply the patches to clean, dry, unbroken areas of your skin, preferably below your waist. You should pas apply the patches near to your breasts. Each time you use a patch, apply it to a different area so that your skin doesn't become irritated.

  • There are several different types of patches, so it is a good idea to check that you have the same patches each time you collect a prescription.

  • With some patches, you will also be given tablets to take on certain days of the month. Read the instructions carefully and if you are not sure when to start taking the tablets, ask your pharmacist for advice.

• Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. Also, regularly check your breasts for any lumps and go for regular breast screening and cervical smear tests.

• If you are due to have an operation, tell the person carrying out the surgery that you are taking HRT, as you may be advised to stop the treatment for a while if you are likely to be on bed rest.

• There are some risks which are associated with HRT - your doctor will discuss the benefits and risks of the treatment with you before you start. The risks are reduced when small doses of HRT are used for short periods of time. If used for a long time the risk of breast cancer and other complications may increase. Because of this, the decision to continue HRT needs to be made individually and your progress should be reviewed at least once a year. If you have any concerns at any time, make an appointment to discuss them with your doctor.

• Travelling that involves long periods of immobility (more than three hours) can increase the risk of serious side-effects and, in rare cases, may lead to blood clots. Taking appropriate exercise during the journey and possibly wearing elastic hosiery can reduce this risk. If you would like more advice about this, speak with your doctor or pharmacist.

• HRT treatments are not suitable for preventing pregnancy. If you are having menstrual periods (and for 1-2 years afterwards) you could still become pregnant. You should pas take the contraceptive pill while you are on HRT - you are advised to use other methods of contraception such as condoms or a cap. Do pas use the rhythm method, as your usual menstrual cycle will become less regular during the menopause and make this method unreliable. If you suspect you might be pregnant, stop taking HRT and speak with your doctor as soon as possible.

• If you pay for your prescriptions and your pack contains more than one type of tablet or patch then you may need to pay two prescription charges.

• If you have diabetes you may need to test your blood more frequently, as the HRT may affect the levels of sugar in your blood. Your doctor will be able to advise you about this.

• Before buying any medicines, check with your pharmacist which medicines are safe for you to take alongside HRT.

En plus de leurs effets bénéfiques, la plupart des médicaments peuvent provoquer des effets secondaires indésirables, bien que tout le monde ne les ressente pas. Ceux-ci s'améliorent généralement à mesure que votre corps s'adapte au nouveau médicament, mais parlez à votre médecin ou à votre pharmacien si l'un des effets secondaires suivants persiste ou devient gênant.

Stop taking HRT and contact your doctor for advice immédiatement if you develop any of the following symptoms:

• Douleur thoracique soudaine.

• Essoufflement soudain, ou si vous crachez du sang.

• Gonflement ou douleur dans une jambe.

• Un mal de tête inhabituellement sévère.

• Yellowing of your skin or the whites of your eyes (jaundice).

If you experience any other symptoms which you think may be due to this medicine, discuss them with your doctor or pharmacist.

• Gardez tous les médicaments hors de la portée et de la vue des enfants.

• Conserver dans un endroit frais et sec, à l'abri de la chaleur et de la lumière directes.