Femoston is one of the most commonly prescribed forms of hormone therapy for menopause in the Netherlands. It combines two hormones in a single tablet: estradiol and dydrogesterone. For most women the side effects of Femoston are mild and temporary, but experiences vary. What can you expect, and how do you choose the form that suits you together with your doctor?
What is Femoston and how does it work?
Femoston is an oral hormone therapy that tops up the oestrogen your body makes less of during menopause. Each tablet contains estradiol, a body-identical form of oestrogen, and dydrogesterone, a progestogen that protects the lining of your womb. You take Femoston daily.
Why include a progestogen alongside oestrogen? If you still have a uterus, oestrogen on its own can thicken the womb lining too much. Dydrogesterone prevents that. If you no longer have a uterus, your doctor usually prescribes oestrogen only.
The difference between Femoston 1/10, 2/10 and continu
Femoston comes in three variants. The sequential forms (1/10 and 2/10) give you a monthly withdrawal bleed and often suit perimenopause. The continuous form gives a low daily dose without bleeding, intended for women who are at least a year postmenopausal. The difference is in the dose and the schedule:
| Form | Estradiol | Dydrogesterone | Schedule | Often used for |
|---|---|---|---|---|
| Femoston 1/10 | 1 mg daily | 10 mg (days 15-28) | Sequential, with a monthly bleed | Perimenopause or early postmenopause |
| Femoston 2/10 | 2 mg daily | 10 mg (days 15-28) | Sequential, with a monthly bleed | When 1/10 gives too little relief |
| Femoston continu | 0.5 mg daily | 2.5 mg (daily) | Continuous, without bleeding | At least 12 months postmenopausal |
Which form suits you depends on your symptoms, your stage in menopause and whether you still menstruate. Your doctor usually starts with the lowest effective dose and adjusts as needed. These doses come from the patient leaflet and the Dutch Farmacotherapeutisch Kompas.
Femoston experiences: what do users say?
Experiences with Femoston are mostly positive, though they differ from person to person. Many women notice fewer hot flushes and better sleep within a few weeks. Others need time to find the right form or dose. These are the experiences women share most often.
Positive experiences: a clear drop in hot flushes and night sweats, a more stable mood, better sleep, the convenience of one tablet a day, and a return of energy.
Points women mention: tender breasts or headaches in the first weeks, a 4 to 12 week wait for the full effect, a monthly bleed with the sequential form, occasional breakthrough bleeding in the early months, and that not every woman tolerates dydrogesterone equally well.
Picture two women of 52 with almost the same hot flushes. One finds relief within a month on Femoston 1/10. The other keeps getting tender breasts and only settles on a patch with separate progesterone. The same symptoms, a different answer.
Side effects of Femoston
Most side effects of Femoston are mild and often settle within two to three months as your body adjusts to the hormones. Common side effects include headache, tender breasts, abdominal or back pain and nausea. Irregular bleeding is most likely in the first months.
Less commonly reported effects are mood changes, migraine and fluid retention. Such complaints do not necessarily mean Femoston is wrong for you; a different dose or form sometimes helps. Contact your doctor about persistent or heavy bleeding, or a painful swollen leg, breathlessness or chest pain, as these can be rare but serious signals.
Benefits and points to consider
The convenience of Femoston is that oestrogen and progestogen are already combined in one daily tablet. One point to consider: because you swallow Femoston, it passes through your liver first. Oral oestrogens therefore carry a slightly higher risk of blood clots (thrombosis) than oestrogen through the skin.
Research in the BMJ (2019) showed that of all oral forms, estradiol with dydrogesterone actually had the lowest thrombosis risk, and that oestrogen through the skin was not linked to increased risk. If you have a raised clot risk, for example through excess weight, smoking or your history, your doctor may consider a transdermal form such as an estradiol patch, gel or Lenzetto spray.
Observational research (the French E3N study, 2008) also suggests the type of progestogen may matter for the longer-term risk profile, with dydrogesterone and body-identical progesterone appearing more favourable than some older progestogens. The choice always stays tailored to you, with your doctor.
Alternatives to Femoston
If Femoston does not suit you, there are other options. The choice depends on whether you want a combined product or oestrogen and progestogen separately, and whether you prefer a tablet or delivery through the skin. We think that choice between a tablet and delivery through the skin deserves more attention than the brand name on the box.
- Transdermal oestrogen such as a Lenzetto spray, estradiol patch or gel, often combined with a separate progestogen
- Other combined tablets or tibolone (Livial)
- Want to understand hormone therapy in general first? Read about experiences with hormone therapy for menopause
Testing your hormones before and during Femoston
Before you start Femoston or another form of hormone therapy, a hormone test can give your doctor a starting point. Values often looked at are oestradiol, FSH and your thyroid (TSH), because thyroid complaints can resemble menopause symptoms.
During use, checking your oestradiol now and then can help fine-tune the dose. With the Menopause blood test from Lunara you can discover your hormone levels, with an assessment by a BIG-registered doctor. Not sure where you are in menopause? Our guide to perimenopause can help.
Frequently asked questions
When should you take Femoston?
You take Femoston every day at about the same time, with or without food. Many women choose the evening, so any nausea is less noticeable. A fixed moment helps you avoid missing a tablet.
How quickly does Femoston work?
Hot flushes and night sweats often ease within a few weeks. The full effect on sleep, mood and energy can take 4 to 12 weeks. If you notice little difference after three months, discuss with your doctor whether the dose or form should change.
Do you gain weight on Femoston?
Many women worry about gaining weight on hormone therapy. Weight gain in menopause is usually linked to age and a changing metabolism, not directly to Femoston itself. Fluid retention in the first weeks can show temporarily on the scales.
How long can you use Femoston?
There is no fixed maximum duration. Many women use hormone therapy for as long as symptoms persist and the benefits outweigh the risks, which you review periodically with your doctor. The lowest effective dose is preferred.
For many women Femoston is an accessible first step into hormone therapy, precisely because everything sits in one tablet. Still, no single form is "the best": the right choice is the one that suits your body, your stage and your preferences. Take your doubts seriously and discuss them openly with your doctor or pharmacist.
Every blood test result includes a professional assessment from a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
References
- Farmacotherapeutisch Kompas. Estradiol/dydrogesterone. Accessed 2026.
- Thuisarts.nl. Menopause complaints. Accessed 2026.
- MacLennan AH, et al. Oral oestrogen and combined oestrogen/progestogen therapy versus placebo for hot flushes. Cochrane Database of Systematic Reviews, 2004. PMID 15495039.
- Vinogradova Y, Coupland C, Hippisley-Cox J. Use of hormone replacement therapy and risk of venous thromboembolism. BMJ, 2019. PMID 30626577.
- Fournier A, et al. Use of different postmenopausal hormone therapies and risk of invasive breast cancer. Journal of Clinical Oncology, 2008. PMID 18323549.
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