An oestrogen HRT
Conjugated oestrogens
An oestrogen hormone replacement therapy used to relieve menopausal symptoms.
What is Conjugated oestrogens?
Conjugated oestrogens are a form of oestrogen used as hormone replacement therapy (HRT) to ease menopausal symptoms such as hot flushes, night sweats and vaginal dryness. They top up the oestrogen the body makes less of around the menopause. If you still have your womb, oestrogen must be balanced with a progestogen to protect the womb lining, because oestrogen on its own can thicken it and raise the risk of womb cancer. As with other HRT, there are small added risks of blood clots, stroke and breast cancer to weigh against the benefits, so it is used at the lowest helpful dose and reviewed regularly.
Education and reference only. This is a plain-language guide to Conjugated oestrogens — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Conjugated oestrogens are a mixture of oestrogen hormones used as hormone replacement therapy. Around the menopause the ovaries make much less oestrogen, which can lead to hot flushes, night sweats, disturbed sleep, mood changes and vaginal dryness. Replacing some of that oestrogen relieves these symptoms for many women. It is taken as a tablet. For a woman who still has her womb, oestrogen is given together with a progestogen (either in the same product or as a separate medicine) to protect the lining of the womb; a woman who has had her womb removed can usually take oestrogen on its own.
How it works
Conjugated oestrogens replace some of the oestrogen the ovaries no longer produce, settling the temperature-control and other body systems that become unsettled when oestrogen falls. This eases hot flushes and night sweats, improves vaginal dryness and can help sleep and mood for some women. Oestrogen also stimulates the lining of the womb to grow, which is helpful in a natural cycle but a problem after the menopause: unopposed growth can lead to overthickening and, over time, a higher risk of womb cancer. Adding a progestogen keeps the lining in check, which is why women with a womb need the two together.
Company & origin
Originated / developed by: Generic (long-established).
A long-established oestrogen-based hormone replacement therapy used in the UK to ease menopausal symptoms.
What it treats
Conditions Conjugated oestrogens is used for
Practical use
How to take Conjugated oestrogens
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take the tablet once a day, at about the same time, as prescribed.
- If you still have your womb, take your progestogen exactly as directed alongside the oestrogen to protect the womb lining.
- Use the lowest dose that controls your symptoms and review it with your prescriber at least once a year.
- Report any unexpected or heavy vaginal bleeding to your prescriber, especially if it is new or persistent.
- Seek urgent help for a painful swollen leg, sudden chest pain or breathlessness, or signs of a stroke such as face drooping or weakness on one side.
Weighing it up
Advantages & disadvantages of Conjugated oestrogens
Advantages
- Very effective at relieving hot flushes, night sweats and vaginal dryness around the menopause.
- Can improve sleep, mood and quality of life for many women during the menopausal transition.
- Helps maintain bone strength, which lowers the risk of osteoporosis-related fractures while it is used.
Disadvantages
- Carries a small added risk of blood clots, stroke and breast cancer that must be weighed against the benefits.
- Women with a womb must also take a progestogen, as oestrogen alone raises the risk of womb cancer.
- Can cause side effects such as breast tenderness, bloating, headaches and irregular bleeding, especially at first.
Practical use
Good to know
HRT is one of the most effective ways to relieve troublesome menopausal symptoms, and for many women started around the time of menopause the benefits outweigh the risks. The single most important point is womb protection: if you still have your womb, you must take a progestogen alongside the oestrogen, because oestrogen alone thickens the womb lining and raises the risk of womb cancer. Like other HRT, it carries a small increase in the risk of blood clots, stroke and breast cancer, which depends on your age, your personal and family history and how long you use it, so it is used at the lowest helpful dose and reviewed at least once a year. Report any unexpected vaginal bleeding, a painful swollen leg, chest pain, breathlessness or signs of a stroke straight away. Keep up breast awareness and attend breast screening, and tell your prescriber about your full medical history, including any history of clots, breast cancer or liver problems.
Who should not take it / use with caution
- Women with a current or past breast cancer or certain other hormone-sensitive cancers should not usually take it.
- It is avoided in those with a history of blood clots, a recent stroke or heart attack, or active liver disease.
- Anyone with unexplained vaginal bleeding should be assessed before starting HRT.
Monitoring
- A review at least once a year to check symptoms, side effects and whether to continue.
- Blood-pressure checks and keeping up with breast screening and breast awareness.
- Prompt assessment of any unexpected vaginal bleeding or possible clot symptoms.
Side effects
- Breast tenderness, bloating, nausea, headaches and leg cramps, particularly in the first weeks.
- Irregular or breakthrough bleeding, which often settles but should be reported if it persists.
- Rarely, blood clots, stroke or other serious effects, which need urgent attention.
Key interactions
- Some medicines for epilepsy and certain antibiotics, and the herbal remedy St John's wort, can lower oestrogen levels.
- It may affect the dose needed of thyroid medicines and some diabetes treatments.
- Tell your prescriber about all your medicines, as HRT can interact with several and influence clotting risk.
Available as: Tablets taken by mouth.
Answers
Conjugated oestrogens: frequently asked questions
What are conjugated oestrogens used for?
They are an oestrogen hormone replacement therapy used to ease menopausal symptoms such as hot flushes, night sweats and vaginal dryness.
Do I need a progestogen as well?
If you still have your womb, yes; a progestogen is needed alongside the oestrogen to protect the womb lining. Women who have had their womb removed can usually take oestrogen alone.
Does HRT increase cancer risk?
There is a small added risk of breast cancer, and oestrogen without a progestogen raises womb-cancer risk, which is why womb protection matters; these risks are weighed against the benefits with your prescriber.
What symptoms mean I should get urgent help?
Seek urgent care for a painful swollen leg, sudden chest pain or breathlessness, or signs of a stroke such as face drooping or one-sided weakness.
How long can I stay on it?
It is used at the lowest helpful dose and reviewed at least once a year, with the decision to continue based on your symptoms and your personal balance of benefits and risks.
The wider class
About Oestrogen (HRT)
Conjugated oestrogens belongs to the oestrogen (hrt) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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