Combined HRT treatment

Continuous combined HRT means you take oestrogen and progestogen every day without a break. This is typically for women who are postmenopausal (at least 12 months since their last period) and is designed to prevent monthly bleeding.

Sequential (or cyclical) HRT means you take oestrogen every day but add progestogen for part of the cycle—usually for 12 to 14 days per month. This mimics a natural menstrual cycle and causes a monthly withdrawal bleed. It’s used for women who are still having periods or are in the later stages of perimenopause.

We prescribe a number of different patch brands through our pharmacy:

• Evorel Sequi
• Evorel Conti

There are two main types of combined patches:

• Continuous patches (for postmenopausal women) – provide both hormones every day, with no bleed.
• Sequential patches (for perimenopausal women) – oestrogen-only patches for part of the cycle, followed by combined patches that include progestogen, which can cause a monthly withdrawal bleed.

HRT patches start working as soon as the hormones are absorbed into your bloodstream, but it can take a few weeks to notice changes. Some symptoms, like hot flushes and night sweats, may improve within a couple of weeks, while others, like mood and energy levels, can take a little longer. Most women feel the full benefit within three months, so it’s worth giving your body time to adjust.

Combined HRT patches contain oestrogen and progestogen. The oestrogen helps relieve menopausal symptoms like hot flushes, joint pain, and brain fog, while the progestogen protects the womb lining from thickening, which is important for women who still have a uterus. The patch releases these hormones steadily into your bloodstream, avoiding the peaks and troughs that can come with tablets.

There’s no strong evidence that combined HRT patches cause weight gain. Some women notice fluid retention or bloating when they start HRT, but this often settles within a few months. Menopause itself can lead to changes in body shape and metabolism, but HRT doesn’t directly cause fat gain.

HRT patches should be applied to a clean, dry, hair-free area of skin below the waist, such as the lower abdomen, buttocks, or upper thigh. Avoid placing them near the waistline, as tight clothing can rub them off. Rotate the site each time you change your patch to reduce the risk of skin irritation.