What are the differences between Femarelle (dtz (dydrogesterone and testosterone)) Rejuvenate, Fortify, and Unison?

Differences Between Femarelle Rejuvenate, Fortify, and Unison

Femarelle products differ primarily in their formulations and target age groups, with each containing different doses of DT56a (a soy-derived selective estrogen receptor modulator) designed for specific stages of menopause.

Overview of Femarelle Products

Femarelle is a line of non-hormonal supplements containing DT56a, a phyto-selective estrogen receptor modulator (SERM) derived from tofu/soy. Each product is formulated for different stages of menopause:

Femarelle Rejuvenate

• Target population: Perimenopausal women (40s)
• Primary purpose: Managing early menopausal symptoms
• Key ingredients: Lower dose of DT56a (approximately 344 mg/day)
• Main benefits: Helps with initial perimenopause symptoms including mood swings, sleep disturbances, and occasional hot flashes

Femarelle Fortify

• Target population: Menopausal women (50s)
• Primary purpose: Managing established menopausal symptoms and bone health
• Key ingredients: Standard dose of DT56a (644 mg/day)
• Main benefits: Reduces hot flashes, night sweats, and helps maintain bone mineral density

Femarelle Unison

• Target population: Post-menopausal women (60+)
• Primary purpose: Vaginal health and urinary symptoms
• Key ingredients: DT56a with additional ingredients targeting vaginal tissue
• Main benefits: Addresses vaginal dryness, urinary symptoms, and sexual function

Efficacy and Mechanism

Research shows that Femarelle products work through selective action on estrogen receptors:

• Studies demonstrate that the standard dose (644 mg/day) used in Fortify significantly increases bone mineral density by 3.6% in the lumbar spine after 12 months, while the lower dose (344 mg/day) used in Rejuvenate did not show this benefit 1

• All formulations effectively reduce menopausal symptoms, with clinical studies showing 75-80% of women experiencing improvement in hot flashes after 8 weeks of treatment 2, 3

• Unlike conventional hormone replacement therapy, Femarelle acts as an estrogen antagonist in breast and uterine tissues, potentially offering a safer profile 3

Safety Profile

Femarelle products have demonstrated favorable safety profiles:

• No significant changes in endometrial thickness or sex hormone levels have been observed in studies 4, 1

• Unlike traditional hormone replacement therapy, Femarelle does not appear to increase thrombotic risk, making it potentially suitable for women with thrombophilia 5

• This is particularly important as conventional hormone therapy is associated with increased risk of thromboembolic events, with combined estrogen and progestin therapy showing a statistically significant increase in DVT risk (HR, 1.88) 6

Clinical Considerations

When choosing between Femarelle products:

1. Age and menopausal stage: Select based on the woman's age and specific stage of menopause

2. Symptom profile:

   • Rejuvenate for early/mild symptoms
   • Fortify for established symptoms plus bone health concerns
   • Unison for predominant vaginal/urinary symptoms

3. Bone health concerns: Fortify with its higher dose (644 mg/day) is the only formulation shown to increase bone mineral density 4, 1

4. Safety considerations: All formulations appear to have minimal impact on endometrial thickness and hormone levels, with no significant adverse effects on platelet function 5

Important Caveats

• While Femarelle products may offer an alternative for women who cannot or choose not to use conventional hormone therapy, they should not be considered equivalent to FDA-approved treatments

• The USPSTF recommends against using hormone therapy for primary prevention of chronic conditions in postmenopausal women 6, but this recommendation does not specifically address Femarelle products

• Long-term safety data beyond 12 months is limited, particularly regarding endometrial and breast tissue effects

• Women with a history of hormone-dependent cancers should consult their healthcare provider before using any products that may have estrogenic effects 7

By understanding the differences between these three Femarelle formulations, healthcare providers can better guide patients toward the most appropriate option based on their specific menopausal stage and symptom profile.