Everol Sequi patches is a sequential or cyclical HRT, for women who are still having periods but have menopausal symptoms. When used correctly they can help treat symptoms of menopause and improve your quality of life.

Everol Sequi patches contain two female sex hormones called oestrogen (estradiol) and progestogen (norethisterone), which are absorbed into your body through patches placed on your skin. These hormones play an essential role in sexual and reproductive development as well as helping to regulate menstrual cycles. When taken as HRT, these hormones replace the hormones in your body that may be at low levels due to menopause.

Everol Sequi arrives in a ‘memory pack’, which can be used to help you keep track of your treatment and remember when to change your patches.

Everol Sequi patches work by replacing hormones that are at low levels as you approach menopause to help relieve its symptoms - this type of treatment is call hormone replacement therapy (HRT).

This is a combined sequential or cyclical HRT, which means you get different hormones at different points in your cycle. The pack includes two types of patches; the first is Evorel 50 (which only contains estradiol) and is used for the first two weeks, and the second is Evorel Conti (containing both estradiol and norethisterone) which is used for the next two weeks. This 4 week cycle is repeated without a gap.

If you take estradiol alone for long periods of time, it can cause the lining of your womb to build up and get thicker, which can cause health problems. This is why two different patches are used. The patches that contain both norethisterone and estradiol help reduce the excess lining of the womb, giving most women a withdrawal bleed (similar to having a period) each month. This should bring up your oestrogen levels which will ease the symptoms of menopause.

Evorel Sequi does not work as a contraceptive, so if it has been less than 12 months since your last period, you should still use contraceptives to avoid pregnancy.

What causes menopause and how do Everol Sequi patches treat it?

Menopause is a normal part of ageing that happens as women’s oestrogen levels begin to drop (usually between the ages of 45 and 55). The lower levels of oestrogen in the body are what cause the negative symptoms associated with menopause. Everol Sequi patches contain synthetic versions of the hormones oestrogen and progesterone, which work together to replace the lower levels of oestrogen. This helps to reduce and relieve symptoms of menopause and improve your quality of life.

What is the typical dosage of Everol Sequi patches?

Each pack of Everol Sequi contains eight patches:

• 4 ‘Evorel 50’ patches which only contain estradiol
• 4 ‘Evorel Conti’ patches which contain estradiol and norethisterone

These patches contain evenly spread hormones that are passed into your body steadily through your skin.

Your doctor will help define the correct dosage for you. You should always use Everol Sequi as prescribed and speak to your doctor if you have any concerns or questions about your dosage.

How long does it take for Evorel Sequi patches to work?

Everol Sequi starts working right away, but it usually takes a few weeks to notice the benefits.

It’s important to remember that the time it takes to feel the effects of Everol Sequi varies from person to person, so your experience and timeline may differ from someone else’s. If you’re worried that your treatment is not working or may not be right for you, you should speak to your doctor about possible solutions or alternative treatments.

How effective are Evorel Sequi patches?

Evorel Sequi is considered to be effective and works well to treat a range of symptoms caused by menopause. This includes physical symptoms such as hot flushes, night sweats and vaginal dryness, as well as psychological symptoms such as depression and mood swings.

It is important to remember that Evorel Sequi affects people differently, so your experience may not be similar to someone else’s. Your doctor will review your treatment with you to gauge whether it has been an effective treatment for you or if an alternative would be more suitable.

You use Evorel Sequi patches by sticking them to your skin so that they can slowly release hormones into your body. It’s important to remember to change your patches at the correct times and to make sure you’re always applying the correct patches. Always use Evorel Sequi patches exactly as prescribed by your doctor.

When should I start using Evorel Sequi patches?

When to apply your first patch depends on a variety of factors.

You apply your first Evorel Sequi patch at any time if:

• Your menstrual cycles are not regular, and you are not pregnant
• You are changing from HRT that does not give you a withdrawal bleed

If you are not currently taking HRT and are still having regular periods:

• Put on an Evorel Sequi patch within 5 days of when you start bleeding.

If you are changing from an HRT medication that gives you withdrawal bleeds:

• Apply your first patch at least 1 week after finishing your current medication or at the end of a treatment cycle

If you are using a type of HRT that differs from the above:

• You should consult your GP as this will be different depending on the medication.

Where to apply the patch

Place the patch on a hairless part of your skin below your waist. Most people prefer to stick the patch on either their thigh or bottom.

Do not:

• Place the patch on or near the breasts
• Place it on or near any skin that’s irritated or spots and cuts
• Use any cream, moisturizer or talcum powder before attempting to stick the patch
• Stick the patch to the same area of skin twice in a row
• Wear tight-fitting clothing over the patch
• Stick the patch under anywhere you’ll cover with anything elasticated or a waistband

Always stick the patch to clean, dry and cool skin as soon as you’ve opened its protective pouch.

How to apply the patch

Before applying each patch, make sure its protective pouch is completely sealed.

1. Open and Peel

• Use the notches on the pouch as a guide to carefully tear it open to remove the patch.
• Bend the patch and peel off half the protective layer to reveal the sticky side. Avoid touching this as it may not stick properly if you do.

2. Apply and Press

• Find your desired location and press the sticky half of the patch against your skin.
• Remove the rest of the protective layer and press down the rest of the patch.
• Firmly place your palms against the patch to make sure it’s firmly stuck.
• Remove the remaining backing and press down the rest of the patch.

If a patch falls off?

• If your patch falls off, apply a new patch of the same type. Follow the above instructions and make sure your skin is dry and cool before applying.
• We recommend having a spare pack of patches available in case you need to replace any that fall off.

How often should I use Evorel Sequi patches?

Each patch should be worn continuously for 3-4 days, which means changing them twice a week. You should always make sure you’re applying your patches in the right order.

For weeks 1 and 2: Use the four Evorel 50 patches one at a time.

For weeks 3 and 4: As soon as you finish your 4th Evorel 50 patch, you should replace it with your first Evorel Conti patch. These should then be used one at a time for two weeks.

You should continue onto your next pack of Evorel Sequi as soon as you finish each one without leaving any breaks between.

How long do I use Evorel Sequi patches for?

Evorel Sequi patches are a sequential or cyclical form of HRT. Your doctor will usually suggest changing your HRT to a continuous form any time after one year of use. It’s important to review this with your doctor before you make any changes.

Can you cut Evorel Sequi patches in half?

We do not recommend cutting Evorel Sequi patches in half under any circumstances. If a patch is broken, you will need to use a replacement patch.

As with all medications, there are side effects associated with Evorel Sequi patches. This does not mean you will definitely get these side effects or any at all, but if you do, you should speak to your doctor or pharmacist.

You may also experience a period where your body adjusts to HRT, which can cause breast tenderness, nausea and leg cramps when you first begin treatment. If you do experience these side effects, you should tell your doctor, but you will most likely be advised to continue with the treatment as they will ease.

Very common (affects more than 1 in 10 people):

• Irritated, itchy, red skin where the patch is applied

Common (affects less than 1 in 10 people):

• Feeling depressed or nervous
• Inappropriate signs of emotion
• Being unable to sleep
• Headache
• Itchy skin or red rash
• Feeling sick (nausea), or having stomach pain wind or other stomach upsets
• Diarrhoea
• Pain including pain in the back, muscles, joints
• Breast pain
• Feeling generally unwell
• Weight gain
• Heavy vaginal bleeding, painful periods
• Water retention or build-up of fluid under the skin (oedema)

Uncommon (affects less than 1 in 100 people):

• Concentration problems
• Feeling dizzy
• More or less interest in sex than usual
• Allergic reaction (hypersensitivity)
• A fungal infection called thrush
• Feeling tired
• Being aware of your heartbeat (palpitations)
• Numb or tingling hands or feet, less skin sensitivity
• Breast lumps (non-cancerous)
• Fuller breasts
• Irregular vaginal bleeding
• Thickening of the lining of the womb

If you notice any of the following side effects, you must remove the patch and immediately seek medical advice.

• Sudden swelling of the face or throat which may cause difficulty in swallowing or breathing, rapid swelling of the hands and feet and stomach cramps
• Yellowing of the skin or whites of the eyes (jaundice) or other liver problems
• Migraine-type headaches for the first time or more frequent
• An increase in blood pressure

Do Evorel Sequi patches affect your weight?

While there have been reports from patients that Evorel Sequi has affected their weight, there is currently no evidence to suggest that HRT leads to weight gain or weight loss.

Do Evorel Sequi patches cause bleeding?

Yes. This is because the Evorel Sequi patches contain oestrogen, which can lead to a build-up of the lining around your womb. This is broken down when using the patches containing progesterone which causes a period like withdrawal bleed.

Evorel Sequi is not suitable for everyone - certain conditions or medications can interact with Evorel Sequi and make it less effective or potentially unsafe. Evorel Sequi is also only for people who still have a womb and want to continue having a period during their treatment.

Do not take Evorel Sequi if:

• You are allergic to any of the ingredients listed on the pack
• You are under 18
• You have (or have ever had) breast cancer
• You have (or are suspected of having) cancer that is made worse by oestrogens (such as endometrial cancer)
• You have a thickening of the lining of the womb which has not been treated (endometrial hyperplasia)
• You have vaginal bleeding you cannot explain
• You have ever had blood clots in a vein
• You have problems with your blood which increases the likelihood of developing a blood clot
• You have ever had blocked arteries that caused angina or a heart attack, or a stroke
• You have (or have ever had) liver disease, and your liver function tests have not returned to normal
• You have a blood problem called “porphyria”

Interactions with Everol Sequi

Before taking Evorel Sequi, you should tell your doctor about any medication you are currently taking. Evorel Sequi has been reported to interact with:

• Medicine for hepatitis C
• St John’s Wort
• Medication for epilepsy
• Certain medicines for tuberculosis
• Medicine for HIV infection
• Bosentan for high blood pressure

While taking HRT, you should always make sure to have regular check-ups with your GP. You should also go for routine breast screening and cervical smear tests, as well as checking your breasts for any changes.

Alternative treatments to Evorel Sequi

If Evorel Sequi is not suitable for you, we may be able to provide an alternative treatment that is more suitable.

Topical cream may be more suitable for you and your lifestyle or tablets. Each of these different treatment options comes with its own set of benefits and risks, so it’s important to review these thoroughly to make the best plan for your needs.

If you’re not sure whether you need HRT treatment or not, we can provide menopause test kits that you can order online, take at home, and get results quickly. We deliver all of our test kits and medication in discreet packaging so you can test on your own terms and in confidence.