Duavive 101: A Progestogen-Free Hormone Therapy Option

Have you heard about the prescription medication called Duavive? I had a great conversation with one of my patients in my office recently about this hormone therapy option and I want you to know more about this hormone therapy option too!

Duavive (known as Duavee in the United States) is a pill taken once daily that contains 0.45mg of conjugated equine estradiol (CEE) and 20mg of a compound called bazedoxifene. Bazedoxifene is NOT a progestogen. Instead, it belongs to a class of compounds known as selective estrogen receptor modulators (SERMs). SERMs behave differently in different parts of the body. Think of it as having a smart key that can unlock some doors but lock others. It is an AGONIST for bone, meaning it has a positive effect on bone to keep them strong and healthy, and it is an ANTAGONIST for breast and endometrial tissue, which prevents these tissues from growing in a harmful way. 

This is a promising option that gives a progestogen-free alternative for women with a uterus.

Duavive is marketed for postmenopausal women, however it can be used off-label for women in perimenopause. One of the main reasons why it’s not labelled as something for women in perimenopause is because there are no studies and therefore no guideline directed care.

Here are some of the pros of Duavive:

• Provides endometrial protection without the need for a progestogen, which we know can increase breast density. This makes Duavive a great option for any woman at higher risk for breast cancer. It is also a great option for women who are intolerant to the oral progesterone component of their menopause hormone therapy (which can happen to approximately 15-20% of women).

• Duavive is an approved therapy for treatment of low bone density as well.

• Convenient to use - single oral tablet.

  
  

Here are some of the cons of Duavive:

• It's not possible to do dose adjustments, it's one fixed single dose (0.45mg Conjugated Equine Estradiol / 20 mg Bazedoxifene).

• Possible venous thromboembolism risk with oral estrogen (I would not recommend this drug for my patients who are smokers, have diabetes, experience migraines or have metabolic syndrome).

As always, make sure to discuss all your menopause hormone therapy options with your healthcare provider!

Would you like to learn more about your menopause hormone therapy options? I have a guide that goes through exactly that! Click here if you would like to learn more.