6.4. Sex hormones
6.4.1. Female sex hormones
6.4.1.1. Oestrogens and HRT
Prescribing Notes:
Used for the short-term treatment of symptoms of oestrogen deficiency, tibolone is not suitable for use in the pre-menopausal stage or within 12 months of the last menstrual period (unless being treated with gonadotrophin releasing hormone analogues).
Prescribing Notes:
Combination of Evorel® 50 patches (containing estradiol) and Evorel® Conti patches (estradiol and norethisterone acetate).
Prescribing Notes:
Available as 1/10 and 2/10 strengths. Contains estradiol and dydrogesterone.
Prescribing Notes:
Transdermal patch containing estradiol. Available in 25, 50, 75 and 100 micrograms/24hour strengths.

Restrictions: Restricted to specialist initiation. Restricted to use in patients for whom bisphosphonates are contraindicated or not appropriate.
Restrictions: Restricted to patients who fail to tolerate oral or patch preparations.
Prescribing Notes:
Strength: 0.6%
6.4.1.2. Progestogens

Restrictions:
The treatment of moderate to severe symptoms of uterine fibroids in adult women is restricted to the following MHRA advice:
- intermittent treatment of moderate to severe symptoms of uterine fibroids in women of reproductive age who are not eligible for surgery
- one course of pre-operative treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age
- treatment is to be initiated and supervised by a physician experienced in the diagnosis and treatment of uterine fibroids
Please refer to MHRA information prior to initiation.
6.4.2. Male sex hormones and antagonists

Restrictions:
All testosterone preparations are restricted to specialist initiation. In addition, testosterone transdermal gel is restricted to use on the recommendation of consultant endocrinologists, urologists and oncologists for patients requiring a transdermal delivery system.