Understanding HRT Patches

HRT patches are a common form of HRT, but there are several different types available.

Oestrogen-only patches

Oestrogen-only patches are suitable for people who have had a hysterectomy or for people who still have their womb and are taking a separate progesterone-based HRT.

These patches work by releasing oestrogen into the bloodstream via the skin to relieve symptoms such as hot flushes, vaginal dryness, and mood swings, caused by a drop in oestrogen levels. Like most HRT methods, they can take up to 3 months to fully work.

Combined oestrogen and progesterone patches

Skin patches that contain a combination of oestrogen and progesterone and are suitable for people who have an intact womb or have not had a hysterectomy.

Combined patches release oestrogen and progesterone gradually over time into your bloodstream. They provide relief from menopause symptoms and protect the womb lining for people who still have a uterus at the same time. They are usually changed every few days and it can take up to 3 months for you to fully notice the benefits.

Continuous vs. sequential therapy options

As well as containing either oestrogen alone or a combination of oestrogen and progesterone, HRT patches can either deliver the hormones continuously or sequentially:

• Continuous therapy – delivers a constant dose of hormones and is suitable for postmenopausal people, those who have not had a period for 12 months.
• Sequential therapy – mimics the natural menstrual cycle by providing different hormone doses throughout the month and is suitable for people who have menopause symptoms but are still having periods.

You may notice an improvement in your symptoms within a few days or weeks, however, it can take up to 3 months for you to fully feel their benefit.

HRT patches offer several advantages, including:

• menopause symptom relief – patches can effectively relieve menopause symptoms including hot flushes, night sweats, vaginal dryness, and mood swings
• non-invasive application – they stick directly to your skin, so can be a good option if you find it difficult to swallow tablets, and they help avoid side effects like indigestion caused by tablets
• lower risk of blood clots – because the hormones in HRT patches are absorbed through the skin, there is a lower risk of blood clots when you use them
• convenient dosing schedule – unlike HRT tablets which need to be taken daily, patches need to be changed either weekly or every few days
• various strengths available – different strength patches are available which makes it easier to adjust your dose if you need a lower or stronger dose
• whole body treatment – patches can target menopause symptoms throughout the body

Before applying an HRT patch, you’ll need to choose where you are going to stick it. You should stick the patch on your skin below your waist, such as your buttocks, hips, or thighs. They must not be stuck near your breasts.

Once you have decided where you are going to put the patch, you’ll need to use the following guidance depending on which type of patch you have been prescribed.

Applying HRT patches:

1. Open and peel the patch – once you have chosen where you are going to apply the patch, tear along the notched edges of the pouch and remove the patch. With the protective backing facing you, bend and peel away half of the backing paper, taking care not to touch the sticky side.
2. Apply the patch – stick the open half of the patch to your skin. Then, remove the other half of the backing paper and press down firmly on the rest of the patch. Use the palm of your hand to press the entire patch onto your skin and make sure it is fully stuck to you.

Each time you change your patch you should choose a new application site to prevent irritation. Once you have removed your old patch and chosen a new site, repeat steps 1 to 4.

To remove the patch:

• peel an edge smoothly away from your skin
• fold the patch in half, so the sticky side sticks to itself and throw it in your household rubbish
• to remove any sticky residue from your skin, use a small amount of baby oil to remove it or it will gradually go away on its own

How to use sequential combined HRT patches

Sequential patches, like Evorel Sequi, are supplied with 2 different patches that need to be changed twice a week and applied in the correct order:

• Weeks 1 and 2 – apply the oestrogen-only patches one at a time and replace them as often as you are instructed.
• Weeks 3 and 4 – apply the combination patches one-at-a-time and replace them every 3 to 4 days or as often as instructed.

You will not have any breaks between the patches.

How long does a patch last?

Depending on the brand, most patches will last between 3 and 7 days. The patches offered by Superdrug Online Doctor need to be replaced as follows:

• Evorel Sequi – twice a week or every 3 or 4 days
• Evorel Conti – twice a week or every 3 or 4 days
• Estradot – twice a week or every 3 or 4 days

How can I stop my HRT patch falling off?

To stop your patch falling off, you should:

• apply it to clean, dry, hairless skin
• press down on the patch firmly after application for about 10 seconds
• wait at least an hour after applying the patch before exercising, showering, or bathing
• rotate application sites each time you change you patch
• follow the instructions in the patient leaflet carefully

Why do HRT patches have to be below the waist?

HRT patches are worn below the waist because the hormones are better absorbed by the fatty tissue on the thigh, buttocks or lower abdomen. They must also be applied below the breast because HRT can increase the risk of breast cancer.

What to do if you forget to change your HRT patch

If you forget to change your HRT patch, change it as soon as you remember, then change it again on your usual scheduled day.

The potential side effects will depend on which type of HRT patch you are using.

Common side effects for the different patches include:

The risk of serious but rare side effects have been reported for all types of HRT, these include a small increase in the risk of developing:

Blood clots

• chest pain or breathlessness
• difficulty speaking
• difficulty moving your arm or leg
• your face has dropped on one side

Allergic reaction

• swelling lips, tongue, or throat
• difficulty breathing or swallowing
• skin, tongue, or lips turn blue
• confusion, drowsiness, or dizziness

If you experience any of the symptoms of an allergic reaction or blood clots, you should call 999 or get someone to take you to A&E straight away.

If you experience any of the following symptoms, you should contact your doctor immediately:

Breast cancer

• lump or changes to your breasts
• dimpling of the skin around your breast
• changes to the appearance of your nipples

Womb cancer

If you experience any changes in vaginal bleeding after you have been taking HRT for more than a few months, you should contact your doctor.

How to manage side effects

Most of the mild side effects of HRT patches can be managed at home.

Headaches

Take over the counter painkillers such as paracetamol to manage the pain. You should also drink plenty of water to help keep you hydrated.

Mood swings

Eating a healthy diet and taking part in regular exercise is a good way to boost mental health. You can also try relaxation techniques or yoga.

Feeling or being sick and diarrhoea

Staying hydrated is important if you experience any of these side effects to avoid dehydration. You can also try eating smaller, more frequent meals consisting of plain or bland foods until the symptoms have passed.

Who should avoid using HRT patches?

HRT patches are not suitable for everyone and should be avoided if you have:

• a history of blood clots or stroke
• or ever have had breast or endometrial (womb) cancer
• undiagnosed vaginal bleeding
• severe liver disease
• uncontrolled high blood pressure
• an allergy to oestrogen, progesterone, or any other ingredients in the HRT patches

It’s important you discuss your family and medical history with your doctor when choosing a suitable method of HRT, so they can make sure it is safe and suitable for you to use.