Evorel Sequi

What is Evorel Sequi?

Evorel Sequi is a sequential combined hormone replacement therapy (HRT) that comes in the form of skin patches. It contains two hormones: estradiol, a form of estrogen, and norethisterone acetate, a type of progesterone (also called a progestogen).

Evorel Sequi is designed to relieve symptoms caused by the hormonal changes of menopause. It is usually prescribed if you are in perimenopause (your periods are irregular but not fully stopped) or if you are in the early stages after menopause and still have your womb.

Because Evorel Sequi follows a sequential treatment cycle, you use estrogen-only patches first, followed by combined estrogen and progesterone patches. This pattern often results in a monthly withdrawal bleed, similar to a light period.

Evorel Sequi is a transdermal HRT, meaning the hormones are delivered through your skin directly into your bloodstream. This provides steady hormone levels and avoids passing through your digestive system.

What is Evorel Sequi used for?

Evorel Sequi is used to treat menopause symptoms caused by low estrogen levels.

During menopause, your body produces less estrogen. This natural change can cause symptoms such as:

• Hot flushes
• Night sweats
• Sleep disturbances
• Mood swings
• Vaginal dryness
• Reduced libido
• Fatigue
• Brain fog

Hot flushes and night sweats are known as vasomotor symptoms, meaning your body’s internal temperature control is disrupted by hormonal changes.

Evorel Sequi may also help maintain bone density. After menopause, lower estrogen levels increase the risk of osteoporosis, a condition where bones become thinner and more fragile. Hormone replacement therapy can help slow bone loss in women at increased fracture risk.

Evorel Sequi is particularly suitable if you still have occasional natural bleeding or are within the first year after your last period.

How does Evorel Sequi work?

Evorel Sequi works by replacing the hormones that decline during menopause.

Estradiol (Estrogen)

Estradiol is chemically similar to the estrogen your body naturally produces. It helps to:

• Reduce hot flushes and night sweats
• Improve vaginal dryness
• Support mood and sleep
• Maintain bone strength

By restoring estrogen levels, Evorel Sequi helps stabilise the systems in your body affected by menopause.

Norethisterone (Progestogen)

If you still have your womb, estrogen alone can cause the lining of your womb (called the endometrium) to thicken too much. Over time, this increases the risk of endometrial cancer.

Norethisterone protects the lining of your womb by preventing excessive thickening. In sequential HRT like Evorel Sequi, progesterone is added during part of the cycle, which may cause a predictable monthly bleed.

Because Evorel Sequi is delivered through the skin, it provides steady hormone absorption and may reduce certain risks compared to oral hormone tablets.

Who should not use Evorel Sequi?

You should not use Evorel Sequi if:

• You have or have had breast cancer
• You have estrogen-dependent cancer (such as cancer of the womb lining)
• You have unexplained vaginal bleeding
• You have untreated endometrial hyperplasia
• You have or have had blood clots (deep vein thrombosis or pulmonary embolism)
• You have a known blood clotting disorder
• You recently had a heart attack or stroke
• You have severe liver disease
• You are allergic to estradiol or norethisterone

Always inform your doctor about your full medical history before starting hormone replacement therapy.

Pregnancy and breastfeeding

Evorel Sequi is not a contraceptive.

You must not use Evorel Sequi if you are pregnant or think you may be pregnant. Pregnancy is still possible during perimenopause.

Evorel Sequi should not be used while breastfeeding.

If you suspect pregnancy while using the patch, remove it and contact your doctor immediately.

How to use Evorel Sequi and dosage

Always use Evorel Sequi exactly as prescribed.

Evorel Sequi contains two types of patches that are used in sequence:

• Estrogen-only patches (first part of the cycle)
• Combined estrogen and progesterone patches (second part of the cycle)

You typically change the patch twice weekly, following the schedule provided by your doctor.

How to apply:

• Apply to clean, dry, unbroken skin
• Place on your lower abdomen or buttocks
• Do not apply to your breasts
• Press firmly for at least 10 seconds
• Rotate application sites to prevent irritation

You may experience a predictable monthly bleed during the progesterone phase. This is expected with sequential HRT.

Your doctor will prescribe the lowest effective dose and review your treatment regularly.

Possible side effects

Like all medicines, Evorel Sequi can cause side effects, although not everyone experiences them.

Common side effects include:

• Breast tenderness
• Headache
• Nausea
• Mood changes
• Skin irritation at the application site
• Scheduled monthly bleeding
• Spotting between cycles

Less common but serious risks associated with HRT include:

• Blood clots
• Stroke
• Breast cancer
• Ovarian cancer
• Heart disease

Your personal risk depends on your age, medical history, family history and how long you use hormone replacement therapy.

Regular follow-up appointments are important.

Important safety information

Before starting Evorel Sequi, you should have a medical consultation.

Tell your doctor if you have ever had:

• High blood pressure
• Diabetes
• Migraine
• Gallstones
• Liver problems
• Fibroids
• Endometriosis
• High triglycerides
• A family history of breast cancer

While using Evorel Sequi:

• Attend regular check-ups
• Continue routine breast screening
• Perform breast self-examinations
• Report unusual vaginal bleeding

Hormone replacement therapy should be reviewed at least once a year to assess benefits and risks.

When to seek medical help

Stop using Evorel Sequi and seek urgent medical care if you experience:

• Painful swelling in one leg
• Sudden chest pain
• Difficulty breathing
• Severe sudden headache
• Vision or speech problems
• Weakness on one side of your body
• Yellowing of skin or eyes
• Signs of a severe allergic reaction

Contact your doctor promptly if you notice:

• Unexpected heavy bleeding
• A new breast lump
• Persistent abdominal pain
• Sudden significant changes in your health

If you are unsure whether your symptoms are related to hormone replacement therapy, you can easily book a secure video consultation with one of our licensed doctors via Transtoyou. They will assess your symptoms and advise you on the safest next steps. If you experience severe or sudden symptoms, seek urgent medical care immediately.