Please note: the information below is intended for general guidance only. EarlyMenopause.com cannot guarantee the current availability (or suitability) of any form of HRT. Consult your doctor for further information.
Contains: Estradiol and norethindrone acetate
Activella is a form of HRT that combines both estrogen and progestin in one pill. Both the estrogen (estradiol) and the progestin (norethrindrone acetate) are plant-based, but only the estrogen is bio-identical. The combo of hormones is the same as in the Combi-Patch, but, of course, Activella is in oral form, not patch form.
With Activella, you get progestin and estradiol daily (continuous HRT), so you don’t get a monthly cycle. (Side note: the most commonly prescribed combination continuous HRT is Prempro — but in the case of Activella, you’re getting both a different estrogen and progestin.)
On the plus side, Activella combines the popular bio-identical form of estrogen (estradiol) with a very commonly used progestin (norethindrone acetate) which tends to cause fewer side effects than other progestins. It’s rather low-dose — on the low side of standard — which can be a good thing, if you’re wary of getting too much hormones. But, on the flip side, it can also be a little too low for women who need higher amounts.
Because it’s a continuous form of HRT, you only have to take one pill a day, and you typically won’t get a period (although you may get some breakthrough bleeding, particularly in the first four months).
All in all, this seems to be a very good option for women who want a “one pill” approach to HRT, plant-based drugs, and bio-identical estrogen. It’s convenient (only one pill to take); and the combination tends to have fewer side effects than those with other combination therapies.
Standard dosage: 1 mg estradiol, 0.5 mg NDA
Pros: Bioidentical estrogen plus a progestin that often causes fewer side effects than MPA; convenient.
Cons: Progestin isn’t bio-identical to the hormones your body naturally makes; might be a bad choice if you’re only recently diagnosed as it is continuous HRT, thus has a higher chance of breakthrough bleeding.