Hormone replacement therapy (HRT): brand names, medicine by medicine

In Italy, hormone replacement therapy (HRT) can also be found in pharmacies as registered medicines with a brand name, as tablets or patches. Below you will find those that combine estradiol with a synthetic progestin, those based on conjugated oestrogens, those based on tibolone, and estradiol valerate, which the body converts into estradiol: for each one, what it contains, how it is taken and whether it is reimbursed by the Italian National Health Service (SSN).

Bioidentical means that the molecule has the same chemical structure as the one produced by the body: this is the difference between bioidentical hormones and other synthetic hormone therapies. The medicines on this page are registered hormone therapies, but their molecules are not bioidentical, or not all of them are: in many of these medicines the oestrogen is estradiol, which is bioidentical, and it is the progestin that is not. Bioidentical hormones also have their own brand names: estradiol as a gel, spray or patch, and micronised progesterone as capsules.

Hormone therapy should be chosen together with your own trusted doctor. It can be synthetic or bioidentical, industrial or compounded, oral or transdermal: what matters is not which, but that a woman who has an indication for it is not left without hormone therapy. In our pathway for bioidentical hormone therapy we always ask for hormone blood tests, to know each woman's starting point: the therapy is built on these results, on symptoms and on medical history, and the dose is then adjusted mainly according to symptoms.

How to read the tables. The regimen column shows how the medicine is taken over the month. The class column gives the classification of AIFA, the Italian Medicines Agency: A means reimbursed by the Italian National Health Service (SSN), C paid for by the patient. The class is assigned to each individual pack: the table gives the class of the packs on the market and, where it is not the same for all of them, says “A or C depending on the pack”. The data on this page were checked against AIFA documents on 27 October 2026.

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Oestrogen and progestin every day: continuous combinations

In women who still have a uterus, the progestin, or progesterone, balances the effect of the oestrogen on the endometrium, which without it thickens, with a higher risk of hyperplasia and of endometrial cancer: that is why all the synthetic combinations in this list contain one.

Micronised progesterone, that is, the bioidentical one, also has other effects: taken in the evening it helps sleep, it acts on the thyroid and, added to the oestrogen, according to some studies it can give an extra benefit to the bones; for this reason it is often used even in women who no longer have a uterus. The synthetic progestins contained in the medicines on this page do not have the same effects: if the uterus has been removed, they are usually not needed.

In continuous combinations, the oestrogen and the progestin are in the same tablet or the same patch, and there are no breaks: the tablet is taken every day, the patch is changed every week. As a rule, there is no monthly bleeding. In the first months there may be light bleeding, which should be checked by a doctor if it lasts for several months, if it appears after a period without bleeding, or if it is heavy.

Continuous combinations of oestrogen and progestin: brand name, active ingredients, form and route, regimen and class.

Brand name	Active ingredients	Form and route	Regimen	Class
Angeliq	estradiol + drospirenone	tablets, by mouth	continuous	A
Paosonelle	estradiol + drospirenone	tablets, by mouth	continuous	A
Activelle	estradiol + norethisterone acetate	tablets, by mouth	continuous	A or C depending on the pack
Paudien	estradiol valerate + dienogest	tablets, by mouth	continuous	C
Femoston 1/5 conti	estradiol + dydrogesterone	tablets, by mouth	continuous	A
Femity	estradiol + levonorgestrel	patch, on the skin, to be changed every week	continuous	A

Paosonelle contains the same two molecules as Angeliq, at the same dose. Femity is the only patch registered in Italy that contains both the oestrogen and the progestin.

Angeliq has been on AIFA's list of medicines in short supply since 22 October 2026, because of “high demand/production problems: rationed distribution”, with the shortage expected to end on 9 December 2026.

What are the brand names of transdermal HRT?

Among the medicines on this page, Femity is the only transdermal one. Estradiol on its own, as a gel, spray or patch, is bioidentical, however. There is also compounded bioidentical hormone therapy by the transdermal route, made to measure for each woman at the pharmacy.

Discover bioidentical HRT

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Oestrogen and progestin in phases: sequential combinations

In sequential regimens, the oestrogen is taken every day and the progestin is added for only part of the month; in some regimens there is also a week's break. At the end of each cycle, bleeding similar to a period usually appears.

Sequential combinations of oestrogen and progestin: brand name, active ingredients, form and route, regimen and class.

Brand name	Active ingredients	Form and route	Regimen	Class
Femoston 1/10 · Femoston 2/10	estradiol + dydrogesterone	tablets, by mouth	sequential: the progestin in the last 14 days of every 28-day cycle	A
Naemis	estradiol + nomegestrol acetate	tablets, by mouth	sequential	A
Climen	estradiol valerate + cyproterone acetate	tablets, by mouth	cyclical: 11 tablets of estradiol valerate only, 10 with cyproterone acetate, then 7 days' break	C

Cyproterone acetate, the progestin in Climen, and nomegestrol acetate, the one in Naemis, should not be used by anyone who has or has had a meningioma, a rare and usually benign tumour of the membranes of the brain. For low-dose cyproterone, as in Climen, this is a precaution taken by the European Medicines Agency (EMA): an increase in risk has not been demonstrated. For nomegestrol acetate, which is high-dose in Naemis, the risk is confirmed when it is taken for long periods, although it remains rare.

For Naemis, AIFA publishes neither the summary of product characteristics (SmPC) nor the patient information leaflet: the data in the table are those of the register of authorised medicines, and the sequential regimen comes from its official classification.

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Tibolone

Once taken, tibolone is rapidly converted by the body into three compounds: two have an action similar to that of oestrogens, the third an action similar to that of progesterone and testosterone. It is taken every day, with no breaks.

Tibolone-based medicines: brand name, active ingredient, form and route, regimen and class.

Brand name	Active ingredient	Form and route	Regimen	Class
Livial	tibolone	tablets, by mouth	continuous	A
Menec	tibolone	tablets, by mouth	continuous	A
Shyla	tibolone	tablets, by mouth	continuous	A
Tibocina	tibolone	tablets, by mouth	continuous	A
Tibolone Aristo	tibolone	tablets, by mouth	continuous	A or C depending on the pack

The pack of Menec containing 3 blisters of 30 tablets has been on AIFA's list of medicines in short supply since 10 September 2025, with no expected end date for the shortage; the one-blister pack is on the market.

Is tibolone a bioidentical hormone?

No. Bioidentical means that the molecule has the same chemical structure as a hormone produced by the body, and tibolone does not correspond to any of the body's hormones: it is the body that converts it, after it is taken, into the three compounds described above.

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Conjugated oestrogens and bazedoxifene

Duavive combines conjugated oestrogens with bazedoxifene, a selective oestrogen receptor modulator (SERM): the conjugated oestrogens relieve the symptoms of menopause, while bazedoxifene, which in the uterus opposes the action of oestrogens, reduces the risk of the endometrium thickening abnormally. It is intended for women who still have a uterus but for whom a progestin is not suitable: here it is bazedoxifene that protects the endometrium.

Conjugated oestrogens and bazedoxifene: brand name, active ingredients, form and route, regimen and class.

Brand name	Active ingredients	Form and route	Regimen	Class
Duavive	conjugated oestrogens + bazedoxifene	modified-release tablets, by mouth	continuous	C

Duavive has been on AIFA's list of medicines in short supply since 31 March 2026, for “commercial reasons: intermittent supplies”, with no expected end date for the shortage and no equivalent medicine. AIFA authorises healthcare facilities that find their supply interrupted to import a similar medicine authorised abroad.

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Progestins to combine with an oestrogen

Some progestins are marketed on their own and are taken together with an oestrogen prescribed separately. Among their indications, AIFA lists balancing, in menopausal hormone therapy, the effect of oestrogens on the endometrium, alongside other authorised indications.

Progestins to combine with an oestrogen: brand name, active ingredient, form and route, regimen and class.

Brand name	Active ingredient	Form and route	Regimen	Class
Provera G	medroxyprogesterone acetate	tablets, by mouth	for part of the cycle, together with the oestrogen	A or C depending on the pack
Dufaston	dydrogesterone	tablets, by mouth	in the last 14 days of every 28-day cycle, together with the oestrogen	A
Lutenyl	nomegestrol acetate	tablets, by mouth	together with the oestrogen	A

For Lutenyl, the summary of product characteristics limits use to cases in which other interventions are not considered appropriate, following the European review of the risk of meningioma: the risk increases with the dose and the duration of therapy, and it should not be used by anyone who has or has had a meningioma.

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Estradiol valerate

Estradiol valerate is an ester of estradiol: during absorption the body splits it and obtains estradiol from it. On its own it is marketed under the name below; together with a synthetic progestin it is in Paudien and in Climen, in the tables above.

Estradiol valerate on its own: brand name, active ingredient, form and route, regimen and class.

Brand name	Active ingredient	Form and route	Regimen	Class
Progynova	estradiol valerate	tablets, by mouth	oestrogen only, one tablet a day	C

If you still have a uterus, Progynova needs to be combined with a progestin or with progesterone, to protect the endometrium. At the pharmacy it is also found in parallel-import packs, under the same name.

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For local use

Promestriene is an oestrogen used by the vaginal route that acts locally, against atrophy of the vulvovaginal mucosa caused by oestrogen deficiency. It is not the only therapy for vaginal dryness: there are also estriol and low-dose estradiol by the vaginal route, prasterone, also by the vaginal route, and ospemifene, as tablets by mouth.

Local therapy: brand name, active ingredient, form and route, use and class.

Brand name	Active ingredient	Form and route	Use	Class
Colpotrophine	promestriene	capsules, by the vaginal route	local	C

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Which ones are reimbursed by the Italian National Health Service (SSN)?

In class A, reimbursed by the SSN, are Livial, Menec, Shyla, Tibocina, Angeliq, Paosonelle, the three Femoston products, Femity, Naemis, Dufaston and Lutenyl. Activelle, Provera G and Tibolone Aristo have packs in class A and packs in class C. In class C, paid for by the patient, are Duavive, Paudien, Climen, Progynova and Colpotrophine.

In the AIFA medicines database (Banca Dati Farmaci), class A is shown as “a totale carico del SSN” (“fully reimbursed by the SSN”); for any share to be paid by the patient, such as the co-payment (“ticket”) where the region provides for one, ask at the pharmacy. Since the class follows the pack, before buying it is worth checking the class of the exact pack in the AIFA medicines database.

Do these medicines make you put on weight?

Weight gain appears among the side effects in the patient information leaflets of some of these medicines: for Femoston it is listed as common, meaning that it can affect up to one woman in ten. It is not the same for all of them: drospirenone, the progestin in Angeliq and Paosonelle, has an action that counteracts fluid retention. In controlled studies, however, hormone therapy overall did not cause more weight gain than placebo: in an individual woman there may be a little fluid retention, especially in the first months, but weight gain in menopause depends mainly on age and on menopause itself.

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If you are already using one of these therapies

If you are using one of these medicines and wonder whether you can switch to bioidentical hormone therapy, the switch is possible and can be made without interrupting your hormones, which reduces the risk of symptoms coming back. There are indicative equivalences between the doses, which the doctor uses as a starting point and then adjusts to your symptoms. If the uterus is present, protection of the endometrium must stay guaranteed during the switch from one therapy to the other as well. The decision is always made with your doctor: a therapy in progress should not be stopped or changed on your own initiative.

Before the medical visit begins, blood tests are needed for the hormone assessment, then there is the preparation at the pharmacy of the compounded medicine with bioidentical hormones: the cost of bioidentical hormone therapy is the sum of these items.