In short
HRT tablets are oral estradiol, alone after a hysterectomy or combined with progesterone, and relieve hot flushes as well as patches: a standard 1 mg dose stops them completely in about 80 percent of women, 8 in 10. Tablets suit healthy women under 60 without migraine, clotting risk, high triglycerides or gallbladder disease. For those, clinical guidance prefers a patch or gel.
Treatment Overview
What are HRT tablets?
HRT tablets contain estradiol, alone or together with a progestogen in one combined tablet. Estradiol is body-identical, the same hormone the ovaries made before menopause. Women with a uterus take a progestogen, either in the combined tablet or as separate micronised progesterone capsules. All HRT forms at a glance: hormone replacement therapy.
Who are HRT tablets suitable for?
HRT tablets suit healthy women under 60 or within 10 years of their last period with moderate to severe symptoms and no reason to avoid the liver route. Clinical guidance advises against oral estradiol with the following conditions:
- Clotting: previous thrombosis or a known clotting tendency, including heterozygous factor V Leiden
- Metabolism: high triglycerides or active gallbladder disease
- Headache: migraine
- Heart: a 10-year cardiovascular risk of 5 percent or more
With any of these, estradiol through the skin is the choice: HRT patches and oestrogen gel.
Should you choose HRT tablets or a patch?
Tablets and patches relieve symptoms equally well and differ in clot risk, routine and effects on blood tests. The table compares the two routes.
| Tablets | Patch or gel | |
|---|---|---|
| Hot flush relief | Equal at equivalent doses | Equal at equivalent doses |
| Blood clots and stroke | Higher risk than the skin route | Lower risk, first choice in guidance |
| Cholesterol | LDL falls, HDL rises | Smaller effect |
| Triglycerides | Rise | No rise |
| Routine | One tablet a day | Patch once or twice a week, or daily gel |
What dose and regimen are used with HRT tablets?
Treatment starts with 0.5 mg oral estradiol daily for moderate symptoms or 1 mg for severe symptoms, according to clinical guidance, and the dose rises if hot flushes persist after 3 to 4 weeks. The progestogen plan depends on the stage of menopause.
| Stage | Usual regimen |
|---|---|
| Perimenopause or first 2 to 3 years after the last period | Estradiol daily plus micronised progesterone 200 mg at bedtime on 12 days a month (cyclic), with a monthly bleed |
| More than 2 to 3 years after the last period | Estradiol daily plus micronised progesterone 100 mg at bedtime every day (continuous), usually without bleeds |
| After hysterectomy | Estradiol alone |
Women under 45 after removal of both ovaries often need 2 mg daily until about 51: early menopause treatment.
How do HRT tablets affect thyroid tablets and blood tests?
Oral estradiol raises binding proteins made in the liver, and that changes three things:
- Thyroid: women on levothyroxine often need a higher dose, so TSH is checked about 6 to 8 weeks after starting
- Cortisol: total cortisol results read falsely high
- Alcohol: alcohol taken with oral estradiol raised blood estradiol about threefold in a study, so alcohol is limited
The skin route avoids these effects and is used when they matter.
Is bleeding normal on HRT tablets?
A monthly bleed is expected on a cyclic regimen in 80 to 90 percent of women, about 9 in 10. On a continuous regimen, irregular bleeding is common in the first 6 months; bleeding after 6 months, heavy bleeding or bleeding after a long bleed-free time needs an assessment: bleeding on HRT.
HRT tablets in Dubai and the UAE
Where do HRT tablets come from in Dubai?
Estradiol tablets, combined tablets and micronised progesterone are prescription medicines dispensed by licensed pharmacies in Dubai. Custom-compounded hormone mixtures are not used, because clinical guidance finds no evidence of safety or effect: bioidentical hormone therapy.
How well known is HRT among women in the UAE?
In a Dubai study of 591 women interviewed in 2020, 82 percent had fair or poor knowledge of menopause, about 8 in 10, and 77 percent did not know when hormone therapy is unsuitable (Menopause, 2021). A 2026 review of 15 studies from Arab countries found hormone therapy use below 20 percent, fewer than 1 in 5 women, in 11 of them, with fear of risks and a preference for herbal remedies as main barriers (Frontiers in Global Women’s Health).
Can you travel with HRT tablets?
Hormone medicines brought into the UAE from abroad travel with the prescription and a doctor’s letter, and controlled medicines need a permit before entry, according to the UAE Embassy guidance. Dr Felix issues a Dubai prescription so treatment continues with local pharmacy supply.
Dr Felix treats within the scope of his Dubai Health Authority licence. When a case needs a specialist view, for example after breast cancer or with a clotting disorder, the treatment decision is made together with an endocrinologist, gynaecologist or oncologist.
Migraine or clot risk? HRT patches and oestrogen gel. Over 60 and still symptomatic? HRT for women over 60. Hormones not an option? non-hormonal menopause treatment.
Who Is a Good Candidate?
- Healthy women under 60 or within 10 years of their last period with moderate to severe hot flushes or night sweats.
- Women who prefer one tablet a day and have no migraine, clotting tendency, high triglycerides or gallbladder disease.
- Women whose skin reacts to patches and gels.
- Women after hysterectomy who need oestrogen alone.
- Previous blood clot, stroke, transient ischaemic attack or a known clotting disorder: tablets are not used.
- Previous breast cancer, coronary heart disease or active liver disease: systemic HRT is not used.
- Migraine, high triglycerides or gallbladder disease: patch or gel instead of tablets.
- Unexplained vaginal bleeding: assessed before any hormone is started.
What Happens During the Consultation
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1
Symptoms and history
Dr Felix reviews your cycle, symptoms, migraine, clots, gallbladder, breast and family history and your current medicines.
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2
Risk check
Blood pressure, weight, cardiovascular risk calculation and breast cancer risk estimate, with lipids and thyroid tests where they matter.
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3
Route decision
A clear answer on whether tablets fit or whether a patch or gel is safer for you.
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4
Plan and review
Starting dose, progesterone plan, what bleeding to expect and a review after about 3 months.
Program Structure & Follow-Up
How is treatment with HRT tablets followed up?
The first review is about 3 months after starting, then once a year, in line with NICE guidance, covering symptom relief, bleeding, blood pressure, breast screening and the dose. After several years on HRT, the dose is reviewed and a gradual taper is tried at a time that fits your symptoms. Continuous care: Women’s Hormone Membership.
Benefits, Limits & Safety
What are the benefits of HRT tablets?
HRT tablets reduce hot flushes by about 75 percent in frequency, 3 in 4 fewer, in pooled trials, improve sleep disturbed by night sweats and protect bone density while they are taken. Oral estradiol also lowers LDL cholesterol.
What are the risks of HRT tablets?
Oral estradiol raises the risk of venous thrombosis and stroke more than the skin route. For healthy women aged 50 to 59 on HRT for 5 years, the absolute risk of complications is very low, according to clinical guidance. Combined HRT raises breast cancer risk slightly after several years. The full risk comparison: HRT benefits and risks.
What the evidence shows
About 75 percent fewer hot flushes in pooled trials; complete relief in about 80 percent of women on 1 mg estradiol.
How you are followed
Review after about 3 months, then yearly: symptoms, bleeding, blood pressure, breast screening, TSH on thyroid tablets.
When HRT tablets are not used
Previous breast cancer, a blood clot or stroke, coronary heart disease, active liver disease or unexplained vaginal bleeding. Patch or gel instead with migraine, high triglycerides or gallbladder disease.
Cost & Program Investment
What treatment with HRT tablets costs depends on the product, the dose and the progesterone plan. Dr Felix explains the figure before any prescription.
Frequently Asked Questions
HRT tablets and patches relieve hot flushes equally well. Patches carry a lower risk of blood clots and stroke, so clinical guidance prefers them for most women and always with migraine, clot risk or high triglycerides.
HRT tablets usually start with 0.5 mg estradiol daily for moderate symptoms or 1 mg for severe symptoms. Women with a uterus add micronised progesterone.
Oral estradiol often raises the levothyroxine dose needed, because it raises the protein that binds thyroid hormone. TSH is checked about 6 to 8 weeks after starting.
HRT tablets do not cause weight gain in trials. Weight gain around menopause comes mainly from age, lower activity and changes in fat distribution.
The cost of HRT tablets in Dubai depends on the product, the dose and the progesterone plan. Dr Felix explains the full cost in the consultation before anything is prescribed.
Evidence
Where this information comes from
Every figure on this page is taken from the sources below. All of them are free to read, so you can check them yourself.
- The 2022 hormone therapy position statement of The North American Menopause Society
- Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline
- Menopause: identification and management (NG23)
- Women’s knowledge and awareness on menopause symptoms and its treatment options remains inadequate: a report from the United Arab Emirates
- Utilisation of hormone replacement therapy in Arab countries: a systematic review
- Permitted prescriptions and drugs while entering the UAE
This page is general medical information and does not replace a personal consultation. Trial results are averages across large groups, not a prediction for any one person.