Femoston Conti

What is Femoston Conti?

Femoston is a range of hormone replacement therapy (HRT) tablets used to treat oestrogen deficiency symptoms in postmenopausal women. Each medicine in the range contains two active ingredients: oestradiol, a form of the hormone oestrogen, and dydrogesterone, a synthetic progestogen. Both of these hormones work together to relieve menopausal symptoms while protecting the lining of the womb in women who still have their uterus. It is a prescription-only medicine (POM).

Femoston Conti is a continuous combined HRT regimen available in two strengths (0.5mg/2.5mg and 1 mg/5 mg). It is taken as one tablet every day without a break and is designed for women who are well established in postmenopause. Most women start with Femoston Conti 0.5mg/2.5mg, with the higher-dose 1mg/5mg version recommended if symptoms are not adequately controlled. Femoston Conti combines both hormones in a single daily tablet taken continuously, which typically eliminates the withdrawal bleed.

At Prescription Doctor, we also stock Femoston 1/10 and 2/10, a combined sequential HRT that has a 28-day treatment cycle. 

How Does Femoston Conti Work for Menopause?

Femoston Conti contains two sex hormones that work to deal with the vasomotor symptoms of menopause, such as hot flushes and sweats. 

Oestradiol

During menopause, the ovaries produce less oestrogen. This lack of oestrogen drives the major symptoms of menopause, including hot flushes, night sweats, vaginal dryness, sleep disturbance, and mood changes. Femoston Conti contains synthetic 17β-oestradiol, a “body identical” hormone that replaces the oestradiol naturally produced in the body. By replacing the loss of oestrogen, Femoston Conti can effectively treat the symptoms of menopause. Oestrogen also plays an important role in maintaining healthy bone density and reducing the risk of osteoporosis. 

Dydrogesterone

Women who still have a uterus (womb) should not take unopposed oestrogen (i.e., without also taking a progestogen). This is due to the risk of excessive womb lining thickening (endometrial hyperplasia) and cancer.

Dydrogesterone is a synthetic progestogen that functions similarly to natural progesterone in the body. Progestogens shift the womb lining from the growing phase into the secretory phase, stabilising and protecting it during oestrogen treatment.

In continuous combined forms of HRT such as Femoston Conti, the daily administration of both oestrogen and a progestogen prevents thickening of the womb lining whilst not usually causing a withdrawal bleed. This differs from Femoston 1/10 and 2/10, in which the progestogen is included only for part of the monthly cycle, resulting in a predictable withdrawal bleed. 

How Long Does Femoston Conti Take to Work?

The exact time it takes for Femoston Conti to work can vary from person to person. Many women report an improvement in symptoms within a few weeks of starting treatment. For continuous forms of HRT like Femoston Conti, it can take up to 3 months to reach its full effect. This is roughly the same for all forms of oral HRT products. If you are worried that Femoston Conti is not adequately treating your symptoms, contact your prescriber. 

How Effective is Femoston Conti? 

Femoston Conti has been studied extensively in clinical trials involving thousands of postmenopausal women, with robust evidence establishing its effectiveness for relieving oestrogen deficiency symptoms. NICE guidance recognises HRT as an effective treatment available for menopausal symptoms, and Femoston's oestradiol component addresses the hormonal deficiency driving them.

Symptom relief is typically achieved within the first few weeks of starting treatment. A Cochrane systematic review (recognised as high-quality clinical research) of randomised, double-blind, placebo-controlled trials found that oral HRT reduced hot flush frequency by approximately 75% and significantly reduced its severity compared with placebo.

The Femoston Conti summary of product characteristics (SmPC) confirms that, in clinical trials, menopausal symptom relief was achieved within the first few weeks with both continuous regimens (0.5mg/2.5mg and 1mg/5mg).

Responses will vary from person to person, and Femoston Conti works best alongside lifestyle measures such as regular exercise, a balanced diet, and reduced alcohol intake. Femoston 1mg/5mg is also licensed for the prevention of osteoporosis in postmenopausal women at high risk who cannot tolerate other approved treatments.

How to Take Femoston Conti (Continuous Combined Regimen)

Detailed instructions on how to take Femoston Conti, including information on switching from other forms of HRT, are available in the Patient Information Leaflet (PIL) that comes with the medication. Do not start taking Femoston Conti until at least 12 months after your last natural period.

Take one tablet daily without breaks between packs. There is no withdrawal bleed, as both hormones are taken every day without cycling. Swallow each tablet whole with water. You can take Femoston Conti with or without food. Try to take each tablet at the same time each day to maintain a consistent balance of hormones in your body. The blisters are marked with the days of the week to help you to remember when to take your tablets. 

Femoston Conti Dosage Information

Femoston Conti is available in two strengths: 0.5mg/2.5mg and 1mg/5mg. The appropriate strength depends on your individual symptoms and medical assessment. If you have not taken HRT before, it is usually recommended that you start on the lower dose. Femoston Conti is generally more suitable for women who have been postmenopausal for at least 12 months and prefer to avoid a monthly withdrawal bleed. 

If You Forget to Take Femoston Conti 

If you have forgotten to take Femoston Conti within the last 12 hours, take it as soon as you remember and then take your next dose at your usual time. If you forget a dose of Femoston Conti and more than 12 hours have passed, skip it and continue as normal the next day. Do not take two tablets to make up for a missed dose. You may experience bleeding or spotting if you miss one or more doses. 

If You Take Too Many Femoston Conti Tablets

Taking too many Femoston Conti tablets is unlikely to cause you any harm. However, you may feel nauseous or vomit, have tender or painful breasts, or experience dizziness, abdominal pain, drowsiness, or withdrawal bleeding. No treatment is necessary, but contact your clinician for advice if you’re worried.

Femoston Conti Side Effects and Cautions

As with most medications, Femoston Conti tablets have the potential to cause side effects, though not everyone will experience them. Some medical conditions may also be more common in women who take HRT compared to those that don’t. It’s therefore essential to have a clear understanding of what to expect before starting treatment. 

Potential Side Effects of Femoston Conti 

The following side effects may occur when taking Femoston Conti. Please note that the table below does not contain a full list of possible adverse reactions. More details can be found within the Patient Information Leaflets for Femoston Conti 0.5mg/2.5mg and Femoston Conti 1mg/5mg.  

Serious side effects are uncommon, but they do occur. If you notice any of the following, stop taking Femoston Conti immediately and contact your doctor:

• Allergic reactions (swelling around the face, tongue, and/or throat, and/or difficulty swallowing or hives, together with difficulty breathing) 
• Heart attack (chest pain) 
• Tumours that may be affected by high levels of progestogens (e.g., meningioma) 
• A large rise in blood pressure (symptoms include headaches, tiredness, and dizziness) 
• Migraine headaches for the first time 
• Signs of a blood clot (painful swelling and redness of the legs, sudden chest pain, or difficulty breathing)

More details can be found within the Patient Information Leaflet enclosed with the medication. If you experience any side effects from the medication, you can report them to your clinician or via the MHRA’s Yellow Card scheme. Doing so could help provide more information about the treatment’s safety profile. 

Serious Side Effects Observed More Often with HRT

The following medical conditions have been reported more often in women using HRT compared to women who don’t:

• Breast cancer
• Abnormal growth or cancer of the womb lining
• Ovarian cancer
• Blood clots in the veins of the legs or lungs
• Heart disease
• Stroke
• Possible memory loss if HRT is started over the age of 65

Femoston Conti includes a progestogen component that protects the womb from the extra risk of womb cancer associated with unopposed oestrogen. However, you should still remain vigilant for abnormal bleeding. See your doctor as soon as possible if you experience irregular or unexpected bleeding or spotting that carries on after the first 6 months of treatment, starts after you have been taking Femoston Conti for 6 months, or carries on after you have stopped taking it. The use of HRT has also been associated with an increased risk of breast and ovarian cancer. The Patient Information Leaflet contains more information about the risk breakdown.

The risk of blood clots in a vein is 1.3 to 3 times higher in women who use HRT. This risk increases with age. Your prescriber will assess your medical history to determine whether you have any risk factors that would increase your risk of blood clots. Women over 60 who use oestrogen-progestogen HRT are slightly more likely to develop heart disease. The risk of stroke is also 1.5 times higher in HRT users, and this risk increases with age.

There is some evidence that there is a higher risk of memory loss in women who start using HRT after the age of 65.

Side Effects Reported With Other HRTs

Some adverse reactions have been reported with other HRTs. These include:

• Blood clots in the arteries
• Muscle twitches you cannot control
• Rash with target-shaped reddening or sores
• Urinary incontinence
• Painful/lumpy breasts
• High levels of certain blood fats
• Increased total thyroid hormones

The above is not an exhaustive list of possible HRT side effects. Please refer to the Patient Information Leaflets for more details.

Femoston Conti Warnings and Interactions

Femoston Conti tablets are prescribed to postmenopausal women with at least 12 months since their last natural period. You should not take the medication if you:

• Have or have ever been diagnosed with meningioma
• Have or have ever had breast cancer, or if you are suspected of having it
• Have cancer that is sensitive to oestrogens, or are suspected of having it
• Have unexplained vaginal bleeding
• Have excessive thickening of the womb lining that is not being treated
• Have or have ever had a blood clot in a vein
• Have a blood clotting disorder
• Have or have ever had a liver disease and your liver function tests have not returned to normal
• Have or recently have had a disease caused by blood clots in the arteries such as a heart attack, stroke or angina
• Have a condition called “porphyria”
• Are allergic to oestradiol, dydrogesterone, or any of the other ingredients in the medication 
• Are pregnant (Femoston is for use in post-menopausal women only)

It’s important that you seek medical advice if you’re unsure whether any of the above applies to you. If any of these conditions appear for the first time while taking Femoston Conti, stop taking it immediately and consult your doctor or clinician.

Precautions Before Taking Femoston Conti

Speak to your clinician or doctor before starting Femoston Conti if you’ve ever had any of the following medical conditions, as they could return or become worse during treatment. You should also see your doctor more often for check-ups:

• Fibroids inside your womb
• Growth of womb lining outside your womb, or a history of excessive growth
• Increased risk of developing blood clots
• Increased risk of developing an oestrogen-sensitive cancer
• High blood pressure
• Liver disorders such as a benign liver tumour
• Diabetes
• Gallstones
• Migraines or severe headaches
• Epilepsy
• Asthma
• Otosclerosis
• A very high level of fat in your blood
• Fluid retention due to cardiac or kidney problems
• Hereditary and acquired angioedema
• Systemic lupus erythematosus (SLE)

Femoston Conti and Other Medicines

Ensure that you tell your clinician or doctor about any other treatments you are taking, or may soon take. This includes those obtained without a prescription, herbal medicines, or other natural products.

Some medications may interfere with the effect of Femoston Conti. These include:

• Epilepsy medicines such as phenobarbital, carbamazepine, and phenytoin
• HIV treatments like nevirapine, efavirenz, ritonavir, and nelfinavir
• Tuberculosis medications such as rifampicin and rifabutin
• Herbal remedies containing St John’s Wort

HRT can also affect the way some other medicines work. For example, taking them with the epilepsy treatment lamotrigine could increase the risk of seizures. Some medicines used to treat hepatitis C may interact with Femoston Conti, so tell your prescriber if you are taking hepatitis C treatment.

Pregnancy and Breastfeeding

Femoston Conti tablets are suitable only for postmenopausal women. If you become pregnant while using the treatment, stop taking it immediately and contact your doctor. Do not use it while breastfeeding. 

Frequently Asked Questions About Femoston Conti Tablets