Novofem

What is Novofem?

Novofem tablets are a combined sequential form of HRT (hormone replacement therapy).

Novofem is used to treat symptoms of menopause and prevent osteoporosis in women who have a uterus, but who have not had a natural period in the last six months.

Combined, sequential HRT treatments (which can also be referred to as cyclical HRT) are taken every day without a break. They contain two active ingredients which relieve menopausal symptoms by imitating the two female sex hormones, oestrogen and progesterone.

What is Novofem used for?

Novofem tablets are used to relieve menopausal symptoms.

Oestrogen is an important female sex hormone. During the menopause, the oestrogen levels in a woman's body drop, which can cause women to experience some unwanted symptoms. Taking Novofem can help to alleviate these symptoms to help you to continue to enjoy your daily life.

Menopausal symptoms Novofem can help with

The menopause experience is different for everyone, so what you go through could vary hugely compared to someone else. However, there are some typical menopause symptoms that most women go through, though these can range in severity from mild to very distressing.

Menopause symptoms include:

• Hot flushes
• Night sweats
• Disturbed sleep and insomnia
• Fatigue
• Reduced sex drive
• Difficulty remembering or concentrating
• Vaginal dryness
• Headaches
• Low mood or depression
• Anxiety
• Irritability
• Mood swings
• Bloating and digestive problems
• Weight gain
• Joint pain
• Muscle tension and tightness
• Fragile bones (osteoporosis)

These are just some of the symptoms of menopause that can occur — for more information on these signs and symptoms, visit our guide on the 34 symptoms of menopause.

Novofem can help to treat these menopause symptoms and provide relief during menopause.

How does Novofem work?

Novofem contains both red and white tablets which contain two ingredients that act in the same way as your naturally occurring sex hormones, oestrogen and progesterone.

The first ingredient contained in both the red and white tablets is estradiol, which is an identical form of oestrogen (which is produced naturally in the ovaries). The white Novofem tablets also contain the substance Norethisterone acetate, which is a synthetic form of progesterone.

Novofem works in the same way as other combined, sequential HRT — using these two ingredients to mimic the natural menstrual cycle of premenopausal women to alleviate symptoms.

For the first 16 days of each pack of Novofem, you will need to take a red tablet that just contains estradiol. In the next 12 days, you will take a white tablet that contains both estradiol and norethisterone acetate.

Most women will experience a monthly bleed like a period at the beginning of each new pack.

Novofem and weight gain

Although Novofem, like other HRT, has been reported to cause weight gain in some people, the evidence suggests that this is more likely to be fluid retention and bloating rather than true weight gain.

During the menopause it is not uncommon for women to gain weight, especially around their abdomen. It is thought that this is partly due to the imbalance in hormones but is also a natural part of ageing for both males and females, as you start to lose muscle mass and your metabolism slows.

Most importantly for both men and women, it is therefore essential that you always try to get enough sleep, eat healthily and exercise regularly as you get older to reduce unwanted weight gain.

Novofem and depression

A more commonly reported symptom of menopausal women is experiencing low mood. Although some women have reported feeling depressed while taking Novofem more often, taking HRT can help to alleviate feelings of both depression and anxiety.

If you are taking Novofem tablets and are suffering from low mood, anxiety or depression it is important that you speak to a doctor or nurse about how you are feeling so they can advise you appropriately about possible support.

Novofem vs Elleste Duet

Elleste Duet tablets are also combined, sequential HRT (or cyclical HRT) that work in the same way as Novofem.

Elleste Duet tablets are produced either containing 1mg or 2mg of the hormone estradiol. Although Elleste Duet has previously been unavailable to purchase from The Independent Pharmacy and other online pharmacies due to a nationwide shortage caused by a manufacturing delay, they are now available. You can buy Elleste Duet tablets here.

Novofem is the recognised alternative to Elleste Duet 1mg tablets. If you are currently prescribed Elleste Duet 2mg tablets, then Kliofem 2mg/1mg tablets are an equivalent alternative treatment.

If you have concerns about Elleste Duet shortages or any other HRT shortages, you should discuss treatment options with your doctor. Your GP or pharmacist should be able to provide guidance on suitable alternatives.

Other hormone replacement therapy (HRT) options

There are a few different types of HRT available to help relieve menopause symptoms.

The HRT treatments currently available from The Independent Pharmacy are:

• Novofem tablets
• Elleste Solo 1mg tablets
• Elleste Solo 2mg tablets
• Elleste Duet 1mg tablets
• Elleste Duet 2mg tablets
• Elleste Duet Conti tablets
• Evorel patches
• Kliovance
• Livial tablets
• Premarin 0.625mg tablets
• Premarin 1.25mg tablets
• Premique Low Dose tablets

These can be broadly split into three categories: sequential or cyclical HRT (like Novofem), Continuous combined HRT, or oestrogen-only HRT.

The type of HRT that is best for you will depend on a number of factors, such as when you had your last period. If you are unsure which is the best option for you, you can either speak to your GP or one of our qualified pharmacists or visit our dedicated menopause treatments page for more information.

Sources

• https://patient.info/medicine/...
• https://www.nhs.uk/conditions/...
• https://thebms.org.uk/
• https://www.novonordisk.co.uk/...
• https://www.guysandstthomas.nh...
• https://bnf.nice.org.uk/drug/e...
• https://www.nhs.uk/conditions/...
• https://www.nhs.uk/conditions/...
• https://www.nhs.uk/conditions/...
• Novofem Patient Information Leaflet: https://www.medicines.org.uk/e...

Novofem dosage

You should try to take Novofem at the same time each day with a glass of water.

Days 1 - 16: Take 1 red tablet once a day

Days 17 - 28: Take 1 white tablet once a day

Novofem tablets are for oral use only and should only be taken by women with a uterus.

You should take Novofem continuously without a break. Once you have finished your pack, start a new pack the next day.

Please ensure that you read the Patient Information Leaflet thoroughly before taking Novofem.

Novofem ingredients

The active ingredients in Novofem are:

• Each red tablet contains 1mg of estradiol 1 mg
• Each white tablet contains 1mg of estradiol 1 mg and 1mg of norethisterone acetate

The inactive ingredients include:

• Lactose monohydrate
• Maize starch
• Magnesium stearate
• Titanium dioxide (E171)
• Propylene glycol
• Red iron oxide (E172)

For a full list of ingredients included in Novofem tablets, please see the Patient Information Leaflet.

Novofem side effects

Novofem, like any other medication, may cause some people to experience side effects. This doesn’t mean that you will definitely experience side effects if you take Novofem — side effects from this HRT are relatively unusual and are generally mild.

You should take time to familiarise yourself with all the warnings and precautions as Novofem, like other HRT, may increase your chances of getting certain health conditions. You should discuss any questions you have with your doctor before taking this medicine.

The most commonly reported side effects associated with Novofem are:

• Headache and migraines
• Breast tenderness
• Vaginal thrush & vaginal bleeding (unexplained vaginal bleeding or breakthrough bleeding)
• Dizziness & sleeplessness
• Indigestion, abdominal pain, wind
• Nausea & vomiting
• Rashes & itching
• Swelling of the hands, ankles and feet and muscle cramps
• Weight gain
• Changes in libido
• Hair loss
• Muscle cramps
• Depression

If you are concerned about any of the side effects we have listed above or they are bothering you, please speak to a pharmacist or doctor for advice.

If you experience severe side effects or an allergic reaction when taking Novofem, you must seek medical advice from your doctor immediately or attend your nearest emergency department as soon as possible.

Please ensure that you have read the full list of reported side effects in the Patient Information Leaflet before starting treatment using Novofem.

Novofem warnings

Please read the full information regarding warnings and precautions detailed in the Patient Information Leaflet before taking Novofem.

Using any HRT treatment, including Novofem, carries risks. You should take time to consider whether you would like to take HRT or if you want to continue taking it. If you have any questions or concerns you should discuss these with your GP or specialist.

Being eligible to get Novofem on repeat prescription from The Independent Pharmacy is reliant on you continuing to see your doctor for a check-up at least once a year. This must include a breast screen, blood pressure and blood tests and a cervical smear test.

If you experience any of the following, before or while using Novofem, stop taking it and consult your doctor immediately:

• You suspect or develop breast or endometrial cancer
• You have any unexplained vaginal bleeding or endometrial hyperplasia
• You have or have ever had a venous blood clot or have a clotting disorder
• You have had a heart attack, stroke or angina

If you have ever experienced any of the following, consult your doctor before starting Novofem and again if your condition worsens during treatment:

• You have recently stopped taking or are currently taking any other prescribed or non-prescribed (including herbal) medication
• Uterine fibroids
• Endometriosis or endometrial hyperplasia
• High blood pressure or very high levels of fat in your blood
• Blood clots
• Kidney, heart or liver disease or disorders
• Diabetes, SLE, epilepsy or asthma
• Gallstones
• Migraine or severe headaches
• Hypothyroidism
• Hereditary angioedema

Your doctor will be able to advise you on how to proceed and suggest alternative treatment options if appropriate.

Novofem and cancer

Research has highlighted that taking a combined oestrogen-progestogen HRT such as Novofem can increase your risk of developing breast cancer and slightly increase your risk of developing ovarian cancer. There is also thought to be a slightly increased risk of developing endometrial cancer.

Novofem and breast cancer

This risk of developing breast cancer appears to increase the longer you take HRT but does return to normal up to five years after stopping treatment.

For this reason, it is recommended that you only take HRT for the shortest amount of time to manage your symptoms.

Novofem and circulation

Taking oral HRT makes you 3 times more likely to experience blood clots and 1.5 times more likely to experience a stroke.

If you think you are developing symptoms of a blood clot at any time, call NHS 111 or are having a stroke call 999.

Novofem in pregnancy & breastfeeding

Novofem is only suitable for menopausal women and is not a contraceptive. If you have had a menstrual period in the last 12 months or are under 50 years old you should discuss contraception with your doctor before taking Novofem.

If you become pregnant while taking Novofem stop taking it straight away and contact your doctor. You should also not take Novofem while breastfeeding.