Activella® (estradiol/norethindrone) is a prescription medication that contains an estrogen hormone and a progesterone hormone. It is approved for the following uses:
- Treating itching, burning, or dryness in or around the vagina due to menopause
- Treating hot flashes due to menopause
- Preventing osteoporosis in postmenopausal women.
For all uses, Activella is approved only for women who still have a uterus (who have not had a hysterectomy).
Activella is made by Novo Nordisk.
During and after menopause, women experience a drop in estrogen levels and a shift in the balance of estrogens that the body produces. Before menopause, the main source of estrogen is produced by the ovaries, and the main type of estrogen produced is known as estradiol. After menopause, the main source of estrogen is androstenedione, which is produced by the adrenal gland and is converted into an estrogen known as estrone. Menopausal symptoms and changes result from the decrease in estrogen and the shift from estradiol to estrone.
Activella contains estradiol along with a progestin hormone (norethindrone). It helps relieve menopausal symptoms by replacing the estrogen that the ovaries no longer produce. Because estrogen helps keep the bones strong, the decrease during menopause causes a significant weakening of the bones, often resulting in osteoporosis. By providing estrogen, Activella can help prevent these menopause-related bone changes.
Norethindrone is added to Activella because giving estrogens without a progestin to postmenopausal women can increase the risk of cancer of the lining of the uterus. Norethindrone (which is a progestin) decreases this risk. Of course, this applies only to women who still have a uterus (who have not had a hysterectomy). For women without a uterus, the norethindrone component is usually considered unnecessary.