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Estradiol valerate / Medroxyprogesterone acetate

Tridestra is a hormone replacement therapy (HRT) that uses two types of hormones to help ease symptoms of menopause.

You can buy your Tridestra repeat prescription through our online pharmacy service. Complete our medical questionnaire and a doctor will review your order. Approved orders are then dispatched from our pharmacy by tracker courier.

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Tridestra is a hormone replacement therapy (HRT) that uses two types of hormones to help ease symptoms of menopause.

You can buy your Tridestra repeat prescription through our online pharmacy service. Complete our medical questionnaire and a doctor will review your order. Approved orders are then dispatched from our pharmacy by tracker courier.

This content was reviewed by a clinician on

09 February 2022
dr daniel

Dr Daniel Atkinson

(GP Clinical Lead - GMC No. 4624794) 09 February 2022
Product information

Tridestra tablets are a hormone replacement therapy to help treat symptoms caused by menopause. The calendar pack helps patients easily keep on track with their prescribed course. 

All women go through the natural process of the menopause. The age at which it starts can vary greatly but the average age in the UK is around 51 years. Regular menstrual periods stop, as the process of ovulation no longer occurs.  

The production of the natural female hormone known as oestrogen decreases over time. The drop in oestrogen levels during the menopause can cause a number of symptoms. Some of the more common symptoms include: hot flushes, night sweats, irritability, vaginal dryness and headaches. It is also important to note that once menopause has started women can become susceptible to the development of osteoporosis, a condition where bone mass decreases. 

Menopausal symptoms do not cause significant problems for all women. The degree of symptoms can vary greatly and mild cases don’t usually require treatment. Severe cases can lead to symptoms that cause significant impact on daily lives and thus require medical intervention, such as HRT. 

There are several types of hormone replacement therapy. The HRT that your doctor suggests for you can depend on your specific situation and past medical history. Oestrogen-only products are more typically supplied to women who may have had part of their womb surgically removed during a hysterectomy. This type of HRT supplements the drop in oestrogen levels to help lessen the symptoms. Combined HRT contains both oestrogen and progesterone. This type of hormone replacement tends to be prescribed to women who have not had their uterus removed. 

Whilst Tridestra is a combined HRT, it is also known as a sequential treatment. Unlike other monthly sequential treatments, Tridestra is a three-month sequence. The white tablets, taken at the beginning of the cycle for the first 70 days, only contain the active ingredient estradiol; the blue tablets taken between days 71 to 84 contain estradiol and medroxyprogesterone; and the yellow tablets taken between days 85 to 91 are a placebo and contain no active ingredient. This sequence can cause a menstrual-like bleed every three months and may be suited to women who are already experiencing infrequent periods. 

You can buy Tridestra through our online pharmacy service. If you have already been using this treatment you can request a repeat prescription by completing our online medical questionnaire. Once you have completed the consultation form, a GMC-registered doctor will review your answers. Approved orders are sent to our dispensing pharmacy, based in the UK. 

All orders are shipped by tracked next-day courier. This means that your medication should be delivered to your door within one working day.

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Page last reviewed:  09/02/2022

Follow the instructions provided by your doctor. Doing so will help to limit the risk of side effects and make sure you get the full benefit of the treatment. 

  1. Always take as directed.
  2. Only take one tablet each day.
  3. Swallow the tablet whole with water.
  4. The tablets are dispensed in a blister foil pack.
  5. Follow the days on the back of the foil pack - you should start by taking tablet number one on strip number one.
  6. Further instructions on taking this treatment can be found in the enclosed leaflet.
  7. Due to the sequential nature of this HRT medicine, it is essential that you follow the correct order.
  8. If you forgot to take your tablet, you should take it as soon as you remember, unless 12 hours have elapsed since your missed dose. In this case leave that tablet and carry on taking the treatment as normal the next day.
  9. If you are switching to this treatment from another HRT medicine, you may need to speak to your doctor to decide how best to make the switch. 

You can find full details on how to take this medicine in the patient information leaflet.

Page last reviewed:  09/02/2022
Side effects

Side effects

It is always important to be aware of the risk for potential side effects when you are taking a medication. Consult your doctor immediately if any of the following symptoms occur: yellowing of the skin or the whites of the eyes; an increase in your blood pressure (symptoms may be headache, tiredness, dizziness); unexplained or first time migraine-type headaches, with or without disturbed vision (these headaches may be an early sign of a stroke); signs of a blood clot such as painful swelling and redness of the legs, sudden chest pain or difficulty breathing; a pain in your chest that spreads to your arm or neck. 

Please refer to the patient information leaflet for further reading on Tidestra and side effects. 

Common  (1 in 10 people or less):

Weight fluctuations, swelling caused by fluid retention, depression, nervousness, lethargy, nausea, vomiting, stomach cramps, flatulence, headache, dizziness, hot flushes, sweating, breast tension and pain, vaginal discharge, bleeding or spotting, disorder of vulva/vagina, menstrual disorder. 

Uncommon (1 in 100 people or less):

Non-cancerous breast tumor, benign growths in the lining of the womb, allergic reaction, increased appetite, high level of cholesterol in the blood, anxiety, inability to sleep, apathy, mood swings, poor concentration, changes in libido and mood, euphoria, agitation, migraine, sensation of tingling, pricking or numbness in skin, trembling, visual impairment, dry eyes, unusually fast or irregular heartbeat, increased blood pressure, superficial inflammation of the veins, redness or red spots on the skin, breathlessness, runny or blocked nose, constipation, indigestion/heartburn, diarrhoea, rectal disorder, acne, hair loss, dry skin, nail problems, skin nodule, excessive hair growth, painful reddish skin nodules, generalised itchy rash, joint disorders, muscle cramps, increased and frequent urge to pass urine, loss of bladder control, bladder infections, discoloured urine, blood in the urine, breast enlargement, breast tenderness, thickening of the lining of the womb, uterine disorder, tiredness, abnormal laboratory tests, weakness, fever, flu-like symptoms, feeling generally unwell. 

Rare (1 in 1,000 people or less):

Contact lens intolerance, change in liver function and biliary flow, skin rash, blood clots in the veins of the legs or lungs, menstrual pain, pre-menstrual like syndrome. 

Frequency unknown: 

Uterine fibroids, worsening of the symptoms of hereditary angioedema, reduced oxygen flow to the brain or to a section of the brain, stomach pain, bloating, yellowing of the skin or eyes, eczema, gallbladder disease, various skin disorders. 

The side effects mentioned here are only a summary, you should read the patient guide for more details or speak to your doctor. 


Taking it with other medicines

There are some drugs that can interact with the way this medication works. You should make your doctor aware of any treatments you are taking, in particular: medicines for epilepsy, such as phenobarbital, phenytoin and carbamazepine; medicines for tuberculosis such as rifampicin, rifabutin; medicines for HIV such as nevirapine, efavirenz, ritonavir and nelfinavir; herbal remedies containing St John’s Wort Hypericum perforatum. 

Conditions to look out for

This product may not be suitable for use in women who also have other medical conditions. Do not use Tidestra if you have or have ever had any of the following: breast cancer; cancer which is sensitive to oestrogens, such as cancer of the womb lining; unexplained vaginal bleeding; excessive thickening of the womb lining that is not being treated; a blood clot in a vein; a blood clotting disorder; a disease caused by blood clots in the arteries, such as a heart attack, stroke or angina; liver disease and your liver function tests have not returned to normal or a rare blood problem called porphyria. 

Do not use Tridestra if you are allergic to Estradiol valerate or Medroxyprogesterone acetate or any of the other ingredients of this medicine or if you have been told that you have an intolerance to some sugars. 

Certain medical factors may also require you to apply special precautionary measures when using this treatment. Refer to the leaflet supplied for a full list of these, and make sure you let your prescriber know if you have any medical conditions or have experienced any in the past.

Regular check-ups

You should arrange regular check up appointments with your GP whilst you are using Tridestra. This should be at least once a year. 

HRT and cancer

Please make yourself familiar with the information on HRT and cancer risk, included in the patient leaflet, before you commence your course of treatment.

Pregnancy and breastfeeding

Do not use this medication if you are pregnant or breastfeeding. If you become pregnant, stop using this medicine and speak to your doctor. 

Driving and using machines

Tridestra should not interfere with your ability to drive or operate machinery.

Lactose intolerance

Speak to your doctor if you have an intolerance to some sugars.

Page last reviewed:  09/02/2022

Can I still drink alcohol?

It is unlikely that alcohol will interfere with the efficacy of this medicine.

Will I still be able to drive?

Yes. Your capacity to drive should not be affected. However, should you experience any side effects that may impact your driving, you should not drive and speak to the prescribing clinician. 

Can I take the medicine while pregnant?

No. Do not use this treatment if you are pregnant or are breastfeeding. 

How should I store it?

Keep away from children, in a safe place and at room temperature.

Am I allergic to anything in the medicine?

The active substances in Tridestra are: estradiol valerate, medroxyprogesterone acetate, lactose, maize starch, gelatin, talc and magnesium stearate, yellow iron oxide and indigo carmine.

Is it available over-the-counter?

Tridestra can only be bought with a valid prescription. 

If you require a renewal of your repeat prescription for Tridestra you can get this through our online pharmacy service. 

Is it right for me?

Symptoms of menopause can be managed with treatment. If you are experiencing symptoms that are impacting your day to day life you should speak to your GP. Your doctor can discuss your treatment options with you and decide if you should use Tridestra. 

Can I buy Tridestra online?

Yes. You can buy Tridestra from our UK pharmacy if you have already been using this medication. Simply fill out our medical questionnaire to order your repeat prescription. 

Your answers will be reviewed by one of our GMC-registered doctors. Once your order is approved, it will be dispensed from our pharmacy and shipped to your door by tracker courier.

Page last reviewed:  09/02/2022
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