Progesterone Troche

Estradiol / Estriol / Progesterone Troche
Usage
Estradiol / estriol / progesterone troche is a compounded bioidentical hormone replacement therapy (HRT) designed to restore hormonal balance in women, particularly during perimenopause and menopause.
It may be prescribed for:
• Menopausal and perimenopausal symptoms (e.g., hot flushes, night sweats, mood changes)
• Hormone deficiency states
• Sleep disturbances and mood changes
• Low libido and reduced wellbeing
• Other practitioner-directed uses in individualised HRT programmes
Troches (lozenges) dissolve in the mouth and allow buccal absorption, helping bypass first-pass metabolism and providing more consistent hormone delivery.

Dosage
Dosage should be individualised and prescribed by a qualified healthcare professional based on symptoms and clinical response.
Typical dosing considerations include:
• Place the troche between the cheek and gum and allow it to dissolve slowly
• Usually administered once daily, or as directed
• Do not chew or swallow whole
• Rotate placement sites in the mouth to minimise irritation
Regular clinical review and dose adjustment are recommended.

Mechanisms of Action
Estradiol & Estriol (Estrogens)
• Bind to estrogen receptors to restore hormonal balance
• Reduce vasomotor symptoms (e.g., hot flushes)
• Improve vaginal tissue health and lubrication
• Support bone density and cardiovascular function
Progesterone
• Balances estrogen effects and provides endometrial protection
• Helps regulate hormonal effects on the uterus
• May support sleep and mood regulation
Buccal absorption allows hormones to enter the systemic circulation without significant first-pass liver metabolism, potentially improving bioavailability.

Contraindications
This formulation should not be used in patients with:
• Hypersensitivity to any component of the formulation
• Known or suspected hormone-dependent cancers (e.g., breast or endometrial cancer)
• Undiagnosed abnormal vaginal bleeding
• Active or history of thromboembolic disorders (e.g., DVT, pulmonary embolism)
• Severe liver disease
• Pregnancy

Precautions
Use with caution in patients with:
• Cardiovascular disease or risk factors
• History of thromboembolism
• Hormone-sensitive conditions
• Liver impairment
• Migraine disorders
Additional considerations include:
• Hormone therapy should be individualised and regularly reviewed
• Use the lowest effective dose for the shortest duration
• Possible side effects may include:
• Breast tenderness
• Fluid retention
• Mood changes
• Headache
• Oral irritation at the site of troche placement
• Regular monitoring and screening (e.g., breast exams) are recommended
Patients should seek medical advice if they experience unusual bleeding, chest pain, severe headaches, or signs of thrombosis.

Storage
• Store below 25°C unless otherwise directed
• Keep in a tightly closed container
• Protect from heat, moisture, and direct light
• Avoid high temperatures, as troches may soften or melt
• Keep out of reach of children and pets
Patients should follow the specific storage instructions provided on the dispensing label supplied by the