The Independent Pharmacy

Elleste Duet And Bleeding - What To Expect When Taking

Andy Boysan
Andy BoysanBPharmDirector & Superintendent Pharmacist

Reviewed on 14 Feb 2024

If you experience severe symptoms around the menopause as a result of the changing hormone levels in your body, you can treat these symptoms with hormone replacement therapy (HRT) like Elleste Duet. But it can sometimes be difficult to get enough information about HRT tablets from your doctor or the internet, such as whether Elleste Duet causes bleeding.

That’s why we’ve created this article — to answer any questions you have about Elleste Duet and bleeding. By reading up on this HRT medication, you’ll be more informed about what to expect, such as if you will have a monthly cycle and menstrual bleeding during use, and whether Elleste Duet can delay periods. You should always discuss starting or changing HRT treatments with your doctor, it is a complex choice and requires medical input and supervision. Understanding more about this HRT will also help you to decide if it may be the right treatment choice for you.

Read on to find out more about Elleste Duet and bleeding.

What is Elleste Duet?

Elleste Duet is a type of hormone replacement therapy (HRT) used to treat symptoms of menopause. These symptoms — which include hot flushes, night sweats, low libido, and distressing psychological effects such as depression and extreme mood swings — can be severe and have a substantial impact on everyday life for some people.

HRT treatments like Elleste Duet ease menopause symptoms by supplementing the body’s natural hormone levels.

Elleste Duet comes in tablets (either 1mg, 2mg or Conti) and is a combined form of HRT — which means it contains two ‘hormones’ as the active ingredients. These ingredients essentially emulate the two female sex hormones: a natural version of the oestrogen (estradiol) and a synthetic version of progesterone (norethisterone).

Combined treatments like Elleste Duet tend to be recommended to women who have started suffering from menopausal symptoms but still have some type of a menstrual cycle (i.e if you experience a monthly bleed). If you have had a hysterectomy or have ever had breast cancer, you are unlikely to be prescribed a combined treatment like Elleste Duet.

You can read reviews of Elleste Duet from real users here.

Elleste Duet Tablets (1mg, 2mg & Conti)
Elleste Duet Tablets (1mg, 2mg & Conti)
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Can you bleed while on Elleste Duet?

Elleste Duet (1mg & 2mg) does normally cause a menstrual bleed towards the end of each monthly cycle, so taking it will usually feel like having a regular period.

This is because Elleste Duet (1mg & 2mg) is a cyclical treatment (also known as sequential); this means that the hormones that each packet of tablets contains changes depending on where you are in your cycle. The first 16 daily tablets in a cycle contain estradiol only (a natural version of the hormone oestrogen), and the final 12 daily tablets contain a combination of estradiol and norethisterone (versions of oestrogen and progesterone).

The cyclical nature of this HRT causes a regular bleed and reduces your risk of endometrial cancer and other complications caused by an uncontrolled increase in oestrogen levels.

You may also experience some spotting or breakthrough bleeding during the first few months of taking Elleste Duet, as your body gets used to the new hormone levels. Accidentally missing a pill or not taking it on time will also make spotting more likely.

If any bleeding continues after the first few months of using Elleste Duet (1mg & 2mg), or after stopping treatment, you should consult your doctor so that this can be looked into more. Similarly, if you are experiencing no bleeding on Elleste Duet (1mg & 2mg), it’s a good idea to talk to your doctor (though some women simply may not experience any bleeding).

You should review your HRT with your GP and have regular gynaecological check-ups at least once a year.

It should be noted that Elleste Duet Conti is a different type of HRT, known as a continuous treatment. This means that it has a continuous dose of progesterone and as such does not cause you to have a monthly bleed.

When starting HRT, your doctor will discuss your options with regards to the variations of Elleste Duet. The choice of whether to be on a sequential (1mg & 2mg) or continuous (Conti) treatment will depend on several factors, such as your age, the severity of your symptoms, your medical history, when you last had a natural period and personal preference.

How long does Elleste Duet take to work?

It usually takes a few weeks before you feel the benefits of HRTs like Elleste Duet. Sometimes it may take up to three months to feel the full effects of hormone replacement therapy, but it is normally much quicker than this. You should see your menopausal symptoms significantly improve within the first few weeks.

Doctors will normally recommend trying a type of HRT for three months or more to see if it works for you. If it doesn’t work in this time, then it’s a good idea to book an appointment with your doctor to assess your options moving forward.

It may also take your body time to get used to Elleste Duet or other HRTs. This could mean that you experience some side effects such as breast tenderness, nausea, and cramps, as well as potential breakthrough bleeding.

To find out more about the possible side effects of Elleste Duet, you can go to our Elleste Duet side effects page.

What happens when you stop taking Elleste Duet?

Most people stop taking HRTs like Elleste Duet once their menopausal symptoms pass, which is usually after a few years.

When you decide to stop taking Elleste Duet, you can do so suddenly or gradually — your doctor will advise you on what is best depending on your personal circumstances. We wouldn't recommend making this decision without medical advice.

However, if you stop taking Elleste Duet suddenly, you may experience menopausal symptoms coming back. Gradually decreasing your HRT dose is usually recommended by doctors because it means your menopausal symptoms are less likely to come back in the short-term.

Speak to your doctor if you have recurring symptoms that carry on for several months after you have finished using Elleste Duet, or if you have severe symptoms, as it might be that you may need to start a course of treatment again.

Does Elleste Duet have withdrawal symptoms?

Elleste Duet is not addictive and therefore does not have withdrawal symptoms. Though as mentioned your menopausal symptoms may reoccur especially if you stop suddenly 'discontinuation' effects can happen.

Discontinuation effects from Elleste Duet are not unusual. Unfortunately, stopping a hormone replacement treatment — especially if it is done suddenly — can trigger withdrawal symptoms.

Elleste Duet discontinuation symptoms can mimic menopausal symptoms, and it may take a few months for your body to get used to your changing hormone levels.

Gradually coming off HRT like Elleste Duet (by slowing reducing your dose over time) is generally advised by doctors to avoid experiencing discontinuation symptoms. This is because it mimics the natural process of the menopause in which your female sex hormones steadily decline over time.

If you experience any breakthrough bleeding or other symptoms that continue after you’ve stopped taking Elleste Duet, it’s a good idea to consult your doctor.

Elleste Duet dosages: Elleste Duet 1mg benefits & Elleste Duet 2mg benefits

Elleste Duet is available in three different strength dosages: Elleste Duet 1mg, Elleste Duet 2mg and Elleste Duet Conti. All are available to purchase from The Independent Pharmacy on the Elleste Duet product page.

In the Elleste Duet 1mg pack, the 16 white tablets contain 1mg estradiol, and the 12 green tablets contain 1mg norethisterone as well as 1mg estradiol. In the 2mg pack, the 16 orange tablets contain 2mg estradiol, and the 12 grey tablets contain 2mg estradiol and 1mg norethisterone. Elleste Duet Conti tablets come in strips of 28 tablets that each contain 2mg estradiol and 1mg norethisterone, the dose does not change throughout the cycle.

There are benefits to Elleste Duet 1mg, 2mg and Conti tablets, depending on your personal circumstances. Your doctor will usually prescribe the 1mg or Conti to start with. If you don’t feel any benefit or see much difference in your symptoms from the 1mg (if prescribed), then they may increase your dose to 2mg.

Can I delay my period on Elleste Duet?

Some women do delay their periods when they are on Elleste Duet by taking extra tablets rather than sticking to the 28-day cycle.

However, this is not recommended by doctors because of the nature of combination HRTs like Elleste Duet. Taking too many estradiol (oestrogen) tablets to hold off your period can be dangerous. An uncontrolled increase in oestrogen levels will cause the uterus lining (the endometrium) to thicken excessively, which substantially increases your risk of various complications, including endometrial cancer.

The norethisterone (progesterone) tablets in your Elleste Duet packet help to balance out this uterus thickening. This causes a regular bleed and strongly reduces your risk of cancer.

If you still really want to delay your period, you should speak to your doctor first, who will be able to advise you further. Doctors only normally prescribe oestrogen-only HRT (which will cause no bleed) to women who have had a hysterectomy (their womb removed) because of the increased risk of womb (endometrial) cancer.

How does Elleste Duet compare to similar medications?

There are other HRT treatments that work in a similar way to Elleste Duet to relieve symptoms of the menopause:

Kliofem & Kliovance vs Elleste Duet 2mg

Like Elleste Duet 2mg tablets, Kliofem and Kliovance are combined cyclical treatments that contain a natural version of oestrogen (estradiol) and a synthetic version of progesterone (norethisterone).

Kliofem is equivalent to Elleste Duet 2mg tablets. Whereas, each Kliovance tablet contains 1mg estradiol and 0.5mg norethisterone. As such, they do not contain as much hormone as Elleste Duet 2mg tablets or Kliofem.

If Elleste Duet 2mg is unavailable, doctors tend to prescribe Kliofem as an alternative.

Click through to find out more about Kliovance dosage and Kliovance side effects.

Novofem or Elleste Duet 1mg tablets

Novofem and Elleste Duet 1mg tablets are equivalent HRTs. They can be interchanged by your GP if either are unavailable for any reason.

Femoston or Elleste Duet

Femoston is another combined HRT medication that is taken in a 28-day cycle like Elleste Duet.

However, Femoston contains slightly different active ingredients to Elleste Duet. Estradiol is still used as the oestrogen supplement, but dydrogesterone is used for the progesterone supplement rather than norethisterone. One tablet containing oestradiol is taken for the first 14 days, followed by 14 days of the combined tablet containing oestradiol and dydrogesterone.

Femoston can be prescribed if you aren’t getting on well with Elleste Duet; the different hormone type in it can work better for some women, improving symptoms and side effects. Of course, there is no right or wrong — it is just a case of finding out which HRT your body reacts better to.


Elleste Duet is a type of hormone replacement therapy (HRT) used to treat symptoms of the menopause, including hot flushes, night sweats, low libido and extreme mood swings.

Elleste Duet (1mg & 2mg) is a cyclical treatment (also known as sequential) that combines two different hormones — a natural version of the oestrogen (estradiol) and a synthetic version of progesterone (norethisterone).

As a result, Elleste Duet (1mg & 2mg) usually causes a menstrual bleed towards the end of each monthly cycle, so Elleste Duet (1mg & 2mg) and bleeding is nothing to worry about — it is completely normal. However, if you take Elleste Duet Conti, you shouldn't normally experience a monthly bleed.

You may also experience spotting or breakthrough bleeding during the first months of taking Elleste Duet. If this lasts for longer than a few months, it’s a good idea to chat to your doctor.

You can buy Elleste Duet in 1mg, 2mg and Conti strengths from The Independent Pharmacy. All you need to do is complete a quick, free online consultation, and you can receive your HRT medication the very next day.


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