Description
How it works
Around the menopause, the ovaries produce much less oestrogen, which can lead to symptoms such as:
- Hot flushes and night sweats
- Sleep disturbance, irritability and low mood
- Vaginal dryness or discomfort during sex
- Joint or muscle aches
Elleste Solo contains estradiol, a form of oestrogen that is chemically identical to the main hormone produced by the ovaries before the menopause. By topping up oestrogen levels, it:
- Helps relieve vasomotor symptoms (hot flushes, night sweats)
- Improves vaginal and urinary symptoms caused by thinning of the tissues
- Supports bone health by reducing the fast bone loss seen after menopause
Because this is an oestrogen-only HRT:
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Women who still have their womb usually need an additional progestogen for 12–14 days of each 28-day cycle to protect the womb lining from becoming too thick (endometrial hyperplasia and cancer risk).
Elleste Solo is not a contraceptive and will not prevent pregnancy.
Who it may be suitable for
Elleste Solo may be suitable for:
- Peri-menopausal and postmenopausal women with bothersome symptoms of oestrogen deficiency that affect quality of life
- Women who have had a hysterectomy (no womb) and need oestrogen-only HRT
- Some women with a uterus where a separate progestogen is also prescribed for part of each cycle
Experience in women over 65 years is limited, so treatment in this age group requires particular caution and regular review.
Who should not take Elleste Solo
Do not use this medicine if you:
- Have breast cancer now, have had it in the past, or are suspected of having it
- Have or are suspected of having an oestrogen-dependent cancer (for example, cancer of the womb)
- Have unexplained vaginal/genital bleeding
- Have untreated endometrial hyperplasia (thickening of the womb lining)
- Have ever had a blood clot in a vein (deep vein thrombosis or pulmonary embolism)
- Have a known thrombophilic disorder (e.g. protein C, protein S or antithrombin deficiency)
- Have active or recent arterial thromboembolic disease, such as angina, heart attack or stroke
- Have acute liver disease, or a history of liver disease while liver tests remain abnormal
- Are allergic to estradiol or any of the ingredients
- Have porphyria
- Are pregnant or breastfeeding
Elleste Solo is not for use in children or adolescents.
Use with extra care / medical supervision
You may still be able to use Elleste Solo , but you will need closer monitoring if you have or have had:
- Fibroids (uterine leiomyoma) or endometriosis
- Risk factors for blood clots (overweight, major surgery, prolonged immobility, family history, systemic lupus erythematosus, cancer)
- Strong family history of breast cancer or other hormone-dependent tumours
- High blood pressure
- Liver disorders, including liver adenoma
- Diabetes, with or without blood vessel involvement
- Gallstones or gallbladder disease
- Migraine or severe headaches
- Systemic lupus erythematosus (SLE)
- Previous endometrial hyperplasia
- Epilepsy, asthma or otosclerosis
- Markedly raised triglycerides
- Tendency to fluid retention, heart or kidney disease
- Hereditary or acquired angioedema
Treatment should be reviewed at least once a year, and continued only while the benefits outweigh the risks.
Side Effects
Like all medicines, Elleste Solo can cause side effects, although not everyone gets them. Many are mild and settle as your body adjusts in the first months.
Commonly reported effects include:
- Mood and nervous system
- Mood changes, including anxiety or low mood
- Headache, sometimes migraine
- Dizziness
- Changes in sex drive (libido)
- Breast and reproductive system
- Breast tenderness, breast pain or enlargement
- Vaginal thrush (candidiasis)
- Vaginal discharge
- Uterine/vaginal bleeding or spotting (metrorrhagia)
- Period-type cramps (dysmenorrhoea) in perimenopausal women
- Premenstrual-type symptoms
- Digestive system
- Nausea, abdominal pain or discomfort
- Indigestion, bloating, flatulence
- Occasionally vomiting
- Skin and hair
- Rash, itching (pruritus)
- Acne or unwanted hair growth (hirsutism)
- Brown patches on the skin (chloasma)
- Rarely, hives (urticaria) or angioedema
- Muscles, joints and general
- Muscle cramps
- Fluid retention and swelling (oedema), e.g. puffy ankles or legs
- Changes in weight (weight gain or loss)
- Liver and gallbladder
- Gallbladder problems or gallstones
- Abnormal liver function, sometimes with jaundice (yellowing of skin/eyes)
- Less common side effects include:
- Visual changes or contact lens intolerance
- Palpitations (awareness of heartbeat)
- Probable dementia when HRT is started after age 65
- Worsening epilepsy or chorea
- Urinary incontinence
Serious but rare risks linked to systemic HRT (oestrogen with or without progestogen) include:
- Breast cancer – risk increases with longer duration of use
- Endometrial cancer in women with a womb using oestrogen without adequate progestogen
- Ovarian cancer (slightly increased risk)
- Blood clots in the legs or lungs (deep vein thrombosis, pulmonary embolism)
- Stroke and coronary artery disease, particularly with increasing age
- Stop treatment and seek urgent medical help if you notice:
- Painful swelling, redness or warmth in one leg
- Sudden chest pain, shortness of breath, or coughing up blood
- Sudden severe headache or migraine, especially with visual or speech problems
- Yellowing of skin or eyes, dark urine, or severe itching
- A new breast lump or nipple changes
- Sudden heavy vaginal bleeding, or any new bleeding after being period-free for some time
Report any persistent, new or troubling symptoms to a doctor or pharmacist.
Patient Information Leaflet
Please see HERE for the Patient Information Leaflet
Additional Info
Key points about Elleste Solo :
- Type of medicine: Oestrogen-only HRT tablet
- Active ingredient: estradiol (as estradiol hemihydrate) per film-coated tablet
- Appearance: White, round, biconvex tablet marked “01” on one side
- Indication: Treatment of oestrogen deficiency symptoms in peri- and postmenopausal women
- Route: Oral – tablet swallowed whole with water
- Womb present: A progestogen should be added for 12–14 days each 28-day cycle to protect the womb lining
- Not contraceptive: Does not prevent pregnancy – use suitable non-hormonal contraception if pregnancy is still possible
- Contains lactose: Each tablet contains 62.8 mg lactose monohydrate and is unsuitable for people with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption
- Driving and machines: Has no or negligible effect on the ability to drive or use machines
- Interactions:
- Medicines that induce liver enzymes (e.g. some epilepsy medicines such as carbamazepine, phenytoin, phenobarbital; rifampicin, rifabutin; some HIV medicines; and St John’s wort) can increase oestrogen breakdown, reducing effect and changing bleeding patterns.
- HRT may reduce lamotrigine levels, which can affect seizure control.
- Oestrogens can alter certain blood test results, especially thyroid and hormone-binding proteins.
Regular check-ups, including breast examinations and mammograms, are recommended while taking HRT.
Directions
Elleste Solo tablets are for oral use.
Usual dose
- One tablet once daily ( estradiol)
- Swallow the tablet whole with water – do not crush or chew it
- Take it at about the same time each day to help you remember
For treating menopausal symptoms, the aim is always to use the lowest effective dose for the shortest duration.
With or without a womb
- If you have had a hysterectomy (no womb):
- Elleste Solo can usually be taken on its own every day (continuous oestrogen-only).
- If you still have your womb:
- A progestogen should be added for 12–14 days of every 28-day cycle to protect the womb lining.
Your prescriber will advise which progestogen to use and how to combine it with Elleste Solo.
When to start
- Women with established amenorrhoea or long gaps between periods:
- Treatment can usually start at any time.
- Women still having periods:
- It is generally advised to start on the first day of bleeding.
- Switching from another HRT:
- From a cyclical/sequential HRT: complete your current cycle, then start Elleste Solo the next day without a break.
- From a continuous combined HRT: you can usually start Elleste Solo at any time if you are not bleeding, or on the first day of a bleed if you still have periodic bleeding.
Always follow the schedule advised by your prescriber.
Missed a dose?
If you forget a tablet:
- If it is within 12 hours of your usual time:
- Take the missed tablet as soon as you remember, then take the next tablet at the normal time.
- If more than 12 hours have passed:
- Skip the missed tablet and take your next tablet at the usual time.
Do not take two tablets together to make up for a missed dose.
Missing tablets can increase the chance of breakthrough bleeding or spotting, especially if you still have your womb.
FAQs
What is Elleste Solo used for?
Elleste Solo is an oestrogen-only HRT tablet used to relieve menopausal symptoms like hot flushes and night sweats; it can be used alone if you have had a hysterectomy or combined with a progestogen if you still have your womb.
Do I need to take a progestogen as well?
If you still have your womb you will typically need to take a progestogen for 12 to 14 days of each cycle to protect the womb lining, whereas those who have had a hysterectomy usually take Elleste Solo on its own unless they have residual endometriosis.
When can I start taking Elleste Solo?
You can generally start treatment at any time if your periods have stopped, but if you still have periods you should start on the first day of bleeding; switching from another HRT depends on your current regimen and specific clinical advice.
Will I still get bleeding while taking Elleste Solo and a progestogen?
Women with a womb taking cyclical progestogen may experience a monthly withdrawal bleed or initial irregular spotting, but any heavy or persistent new bleeding after being period-free must be checked by a professional.
What if I miss a tablet?
If you miss a dose by less than 12 hours you should take it immediately, but if more than 12 hours have passed you must skip it and resume your normal schedule without doubling up, though this may lead to spotting.
Does Elleste Solo cause weight gain?
Weight changes and fluid retention are possible but do not affect everyone, and since menopause is naturally linked to weight fluctuations, staying active and eating a balanced diet remains important for management.
What serious risks are associated with HRT like Elleste Solo?
Systemic HRT carries small increased risks of breast, endometrial, and ovarian cancers, along with blood clots, stroke, and heart disease, all of which will be weighed against the benefits during your regular 24 HR Pharmacy reviews.
Can I take Elleste Solo with my other medicines?
Certain medications for epilepsy, HIV, or tuberculosis, as well as St John’s wort, can reduce HRT effectiveness, and Elleste Solo can also lower lamotrigine levels, so you must disclose all medicines and supplements to your clinician.
How long can I stay on Elleste Solo?
There is no set maximum duration, but the recommendation is to use the lowest effective dose for the shortest necessary time with at least one annual review to decide on continuing or adjusting treatment.
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