5mg & 10mg Tablets

 When being used for Gender Dysphoria, must only be prescribed on the advice of a specialist centre under shared care arrangements

5mg Tablets

 When being used for Gender Dysphoria, must only be prescribed on the advice of a specialist centre under shared care arrangements

 orally for HRT 

 vaginally (off label). GPs may continue therapy after initiation and stabilisation by a specialist (i.e. a clinician with expertise in the treatment of the menopause (Defined as a Consultant Endocrinologist/Gynaecologist or a primary care clinician who has relevant experience and is clinically competent to prescribe)).

 Not suitable for peanut allergic patients (contains Soybean lecithin)

Entry reviewed: July 2025

200mg & 400mg Pessaries

 Unlicensed use for threatened miscarriage - confirm viable pregnancy via scan prior to initiation

 Off-label use for HRT where micronised progesterone oral, used vaginally, has not been tolerated. GPs may continue therapy after initiation and stabilisation by a specialist (i.e a clinician with expertise in the treatment of the menopause (Defined as a Consultant Endocrinologist/Gynaecologist or a primary care clinician who has relevant experience and is clinically competent to prescribe)).

Entry reviewed: March 2025

 Hospital only prescribing for newly restricted indications:

Indicated only for intermittent treatment of moderate to severe symptoms of uterine fibroids in adult women who have not reached menopause when uterine fibroid embolisation and/or surgical treatment options are not suitable or have failed. 

Refer to MHRA safety updates.

If considered to be appropriate therapy, the risks and benefits of Esmya® should be discussed with patients before prescribing so that they can make an informed decision about treatment options. Liver function should be monitored before, during, and after treatment courses.