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Estradiol Valerate/Norethisterone

Climesse is a combined hormone replacement therapy pill, used to help reduce symptoms associated with the menopause.

Finding time to pick up your regular medication in person isn’t always easy. Here at Treated.com, you can get access to the repeat prescription treatment you need by completing our simple online questionnaire.

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PLEASE NOTE: This treatment is not available through our online pharmacy service. This page is for information only. If you are experiencing any of the symptoms related to the condition(s) this medication treats, we strongly recommend that you see your GP in person.

This content was reviewed by a clinician on

12 November 2020
dr daniel

Dr Daniel Atkinson

(GP Clinical Lead - GMC No. 4624794) 12 November 2020
Product information

Climesse is a pill used in HRT, manufactured and marketed for purchase in the UK by Novartis. It contains synthetic hormones, which treat the symptoms of the menopause by supplementing the levels of progestogen and oestrogen in the body. These tablets are taken once daily.

  1. Branded Novartis product
  2. Simple one a day pill
  3. Provides relief from symptoms

The menopause is a natural process which every woman goes through when they reach a certain age. It is characterised by the conclusion of menstruation; the ovaries no longer produce an egg, and periodic bleeding slows down before coming to a stop. Changing hormone levels play a vital role in this process. Ovulation winds down when the amount of oestrogen the body produces decreases.

It is estimated by the NHS that the average age at which someone will encounter the menopause is 51, although it can occur during a woman’s 40s, or in rarer cases as early as in their 30s. Sometimes, it can be brought on early by an illness, such as Addison’s disease or an underactive thyroid. Surgical procedures, such as womb or ovary removal, can also induce early menopause.

The reduced presence of oestrogen in the body may result in the appearance of certain emotional or physical symptoms. These might include mood swings, depression, an inability to sleep caused by night sweats, or flushing. It is also increasingly thought that the risk of osteoporosis is higher postmenopause too, as oestrogen plays a vital role in maintaining bone integrity.

In the majority of cases, symptoms may be so mild that they do not require attention. Others, however, may feel that they need to seek treatment if the emotional or physical effects of the menopause are causing them problems. HRT, or hormone replacement therapy, is a route which many women in this situation take.

Climesse is a combined HRT pill, which means that it contains two artificial hormones. Estradiol valerate works in the body by mimicking the function of oestrogen. This compensates for falling levels of the hormone in the body, and alleviates symptoms which this decrease may result in.

Norethisterone is a man-made progestogen, and when used in HRT, provides a counteraction to supplemented oestrogen levels. If the levels of oestrogen in the body rise too much due to being unopposed, the lining of the uterine wall can thicken to a point where it may present a risk of developing into endometrial cancer. Norethisterone tempers this process, by keeping oestrogen levels in check and maintaining a hormonal balance.

If you have recently begun experiencing symptoms of the menopause and would like to know more about treatment, you should see your GP in person.

If you’re already taking this treatment, getting your repeat prescription for Climesse is easy with our online service. It takes no longer than a few minutes to complete a medical questionnaire, following which your case will be assessed by a registered practitioner. Once approved, your order will dispensed by our UK-based pharmacy and shipped by our delivery partners directly to your door.

Page last reviewed:  12/11/2020


To get the best possible results from this item, make sure you follow the directions issued by your prescriber. Adhering to the instructions in the patient information leaflet will help you to limit the risk of possible side effects.

  1. Take as directed by your consultant.
  2. This will be one pill, taken daily, at the same time each day.
  3. One strip contains 28 tablets. After you have finished one pack, move on to the next.
  4. The strips are marked with arrows and days of the week to help you keep track of your treatment.
  5. After a period, you may need to undergo review with your doctor to determine whether HRT is still required.
  6. Swallow each pill whole with water.
  7. Do not take more than the amount specified by your prescriber.
  8. If you miss a dose, try to take it when you remember, within 12 hours of your usual time. If this is not possible, skip the missed dose and take your next one as normal.

The above instructions are provided only as a summary. Refer to those included in the leaflet supplied before using this pill.

Page last reviewed:  12/11/2020
Side effects & Warnings

Side effects

It is essential to be aware of the potential side effects this therapy may cause, as some may require you to seek medical advice.

Go to your nearest doctor or hospital right away if you experience: unexpected vaginal bleeding or spotting after a period of use, or upon stopping treatment; menstrual pain; swelling and redness in the legs; sudden chest pain; breathing difficulty; pain in your chest which spreads to your arm or neck; jaundice; rapid increase in blood pressure; the sudden appearance of migraines; or breast changes, including the development of lumps.

Other side effects:

Breast pain or enlargement, vaginal discharge, headache, dizziness, vertigo, tiredness, changes in libido, depression, rise in blood pressure, palpitations, tender or painful veins, fluid retention, nose bleeds, indigestion, wind, nausea, vomiting, abdominal pain, bloating, problems with your gallbladder, itching, hair loss, hives and skin rash, acne, weight gain, leg cramps, or fibroids.

This is not a complete account of the associated side effects. You can find out more by reading the patient information leaflet.


Taking it with other medicines

Let your doctor know if you are using any other prescription, non-prescription or remedial products prior to use. Climesse may interact with the following: antiepileptics such as phenobarbital, phenytoin, or carbamazepine; treatments for tuberculosis, for instance rifampicin or rifabutin; HIV drugs such as nevirapine, efavirenz, ritonavir, telaprevir, or nelfinavir; or St John's wort.

Conditions to look out for

When completing our questionnaire, make sure you disclose any requested information relating to your medical history. This item is not suitable for those who have or have had: breast cancer, or any other type which is sensitive to oestrogens; unexplained vaginal bleeding; endometrial hyperplasia; severe kidney disease; a blood clot or blood clotting disorder; a heart attack or stroke; angina; liver disease from which you have not yet completely recovered; or porphyria.

It may also not be recommended in (or only issued with special care to) those who have a history of: fibroids inside the womb; endometriosis; any condition or health factor which puts you at increased risk of developing blood clots or cancer; high blood pressure; a liver disorder; diabetes; gallstones; migraine; lupus; epilepsy; asthma; otosclerosis; high triglycerides; fluid retention due; hypothyroidism; or angioedema.

Regular check-ups

You will need to have regular reviews (at least one a year) with your GP when taking this treatment.

HRT and cancer

Please read the leaflet provided for detailed information on HRT and cancer risk.

Pregnancy and breastfeeding

This HRT pill is for use in postmenopausal women only. If you become pregnant, stop taking it and tell your doctor.

Climesse must not be taken during pregnancy or breastfeeding.

Driving and using machinery

This pill is not thought to affect users capacity to drive or operate machinery.

Page last reviewed:  12/11/2020

Can I still drink alcohol?

Yes. It is not thought that this product is affected by alcohol.

Will I still be able to drive?

Yes. It is not likely that Climesse will interfere with your capacity to drive, but if you notice any side effects which may make it unsafe to do so, do not drive and let your doctor know as soon as possible.

Can I take the medicine while pregnant?

No. It is not suitable for women who are pregnant or breastfeeding.

How should I store it?

Keep in a safe environment below 25°C.

Am I allergic to anything in the medicine?

This product contains: estradiol valerate, norethisterone, lactose monohydrate, maize starch, povidone, purified water, talc, magnesium stearate, hypromellose, polyethylene glycol, iron oxide red (E172), and titanium dioxide (E171).

Do not take it if you are allergic to any of these ingredients.

Is it available over-the-counter?

Climesse is prescription-only. Our service enables you to have your case reviewed by a doctor, who will issue a prescription if your chosen medication is suitable for you.

Is it right for me?

The HRT pill you use will be determined during consultation with your GP. They will initiate a prescription for the most suitable option.

If you want to renew your regular prescription treatment and have it delivered direct to your home, then our service is provides everything you need. Once you have completed our confidential questionnaire, a doctor will review your case. Following approval, your treatment will be dispensed by our UK pharmacy and shipped to your door via secure next-day delivery.

Page last reviewed:  12/11/2020
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