Understanding HRT Patches

headshot of medical editor brenda Ikeji

Medically reviewed by

Dr. Ikeji

Last reviewed: 12 Mar 2025

Hormone replacement patches are a popular convenient way to manage menopause symptoms. The patches are small and stick directly to your skin, usually on your lower body, to deliver hormones into your bloodstream gradually over time.

HRT patches relieve menopause symptoms such as hot flushes, night sweats, and mood changes. Depending on which brand you are prescribed, HRT patches are usually changed every few days.

Here we explore the different types of HRT patches, the pros and cons of using them, and how they compare to other types of HRT. So, you can make an informed choice about which HRT method will be best for you.

A Lady with her white top pulled up displaying her HRT patch on her tummy

Types of 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.

Benefits of using HRT patches

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

How to use HRT patches

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:

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.

Potential side effects of HRT patches

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

Common side effects for the different patches include:

Oestrogen-only Combined oestrogen and progesterone
  • headaches
  • vaginal bleeding
  • feeling sick (nausea)
  • leg cramps
  • mild rash
  • itching
  • diarrhoea
  • hair loss
  • tender or painful breasts
  • feeling sick (nausea)
  • headaches
  • breast tenderness or pain
  • unexpected vaginal bleeding
  • feeling sick
  • mood changes
  • muscle cramps
  • diarrhoea
  • mild rash or itchy skin
  • hives
  • 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.

    Comparing HRT patches to other forms of HRT

    HRT patches are one of several hormone replacement therapies available. Each form has its own advantages and disadvantages, depending on your individual needs and lifestyle.

    Advantages of HRT patches

    Some of the advantages of HRT patches, include:

    • good option for people who cannot or choose not to swallow pills
    • avoiding gastrointestinal side effects like indigestion
    • a lower risk of blood clots
    • preventing osteoporosis
    • available in sequential or continuous therapy or oestrogen-only or combined forms

    Disadvantages of HRT patches

    Some of the downsides of using HRT patches are they:

    • can cause skin irritation or redness at the application site
    • may not stick well, especially if exposed to excessive sweating or exercise
    • may leave a mark on your skin
    • may not align with your symptom patterns

    HRT patches vs. tablets

    HRT patches and tablets both deliver hormones to manage menopause symptoms, but they work in different ways. Patches may be easier to use and are less likely to cause digestive issues. They are also associated with a lower risk of blood clots because they deliver hormones straight into the bloodstream.

    However, some people find tablets more effective for managing symptoms, like night sweats and hot flushes.

    Combined HRT, including tablets and patches, can help to prevent osteoporosis. There is also an increased risk of blood clots when taking HRT tablets, which may make patches more suitable if you are at higher risk.

    HRT patches vs. gels and sprays

    The table below shows some of the advantages and disadvantages of HRT patches, gels, and sprays:

    Advantages Disadvantages
    Patches
  • available in different strengths
  • need to be changed once or twice a week
  • easy to use
  • can leave marks on your skin
  • may come off
  • Gels
  • easy application to shoulder, thighs, or arms
  • adjustable dose
  • can be used alongside progesterone HRT
  • can take 5 minutes or more to dry
  • Sprays
  • spray directly onto your skin
  • less likely to cause skin irritation
  • easily adjust the dose by changing the number of sprays
  • may need to be applied frequently to control symptoms
  • Factors to consider when choosing the right HRT form

    When choosing the right form of HRT for you, you should consider:

    • lifestyle – patches require less frequent application than gels, sprays, and tablets, they can cause skin irritation or if you exercise regularly or sweat excessively, there is a risk your patch may fall off
    • skin sensitivity – if you have sensitive skin, patches may not be the best option for you
    • medical history – if you are at a higher risk of blood clots, patches, sprays, or gels may be a better option
    • the stage of menopause you’re at – where you’re at in your menopause journey can determine which type of HRT you need
    • whether you have an intact womb – if you have your womb intact you will need to take a combination of oestrogen and progesterone

    Can you combine different forms of HRT?

    Yes, you can use a combination of patches, gels, or tablets if you require combined HRT. Your doctor will discuss how to combine HRT methods with you.

    Switching to patches from another type of HRT

    Switching from oral HRT to HRT patches will depend on what type of patch you are using.

    Before making any changes to your HRT, you should discuss your current symptoms, medical history, and reasons for wanting to switch with your doctor. This will help them assess which method of HRT will be most suitable for you.

    If you are switching to oestrogen-only patches and you still have your womb intact, you will need to take a separate progesterone HRT, such as Utrogestan.

    Switching to continuous combined HRT patches

    You can start using continuous combined HRT patches straight away if:

    • your periods have stopped for at least 12 months and you haven’t been taking HRT
    • you are switching from another type of continuous combined HRT such as tablets

    If you have been using sequential combined HRT, wait until the end of the current treatment cycle before starting your new patches.

    When you have switched to HRT patches, it can take up to 3 months for you to notice any difference to your symptoms. So, it is important to give the medication time to act on your system. However, if you are worried or are experiencing any side effects, you should speak to your doctor or pharmacist for advice.

    Summary

    HRT patches are an effective and convenient method for managing menopause symptoms in both menopausal and postmenopausal people. They offer benefits such as a lower risk of blood clots compared to oral HRT, and they can prevent osteoporosis, but some people may experience skin irritation.

    Superdrug Online Doctor HRT and menopause service can help you find the most suitable HRT for your symptoms. If you’re not sure if the symptoms you are experiencing are linked to menopause, you can order a home menopause test kit to find out if you’re ready for HRT.

    HRT patches FAQs

    Do HRT patches cause weight gain?

    No, there is no evidence that HRT patches cause weight gain. However, weight gain around menopause is common and can happen even if you do not take HRT.

    Do HRT patches reduce belly fat?

    Some research suggests that HRT can redistribute abdominal fat which may have protective benefits against cardiovascular disease. However, HRT is not a weight loss medication and you may not experience any weight-related effects when using HRT patches. The best way to manage your weight during menopause is by eating a healthy, balanced diet and getting regular exercise.

    Can you drink alcohol on HRT patches?

    Yes, you can drink alcohol while using HRT patches, but it is advisable to cut down your intake because this may help reduce some of the vasomotor symptoms such as hot flushes. Alcohol can also increase your calorie intake and may cause weight gain.

    Can you smoke on HRT patches?

    It is not advisable to smoke while using HRT patches, this is because it can reduce the effectiveness of the medication.

    Do you still have periods on HRT patches?

    If you use continuous HRT patches you won’t have a monthly bleed. However, sequential HRT patches may cause you to have a period-like bleed each month.

    Can you get pregnant on HRT patches?

    Yes, HRT is not contraception, so you can still get pregnant.

    Can you cut HRT patches in half?

    Yes, it may be possible to cut an HRT patch in half for a smaller dose, but you must speak to your doctor before doing this. If you feel like your dose is too strong, your doctor may suggest cutting the dose down or trying a different form of HRT.

    Can HRT patches cause bleeding?

    Yes, one of the side effects of combined HRT patches is irregular vaginal bleeding or spotting during the first 4 to 6 months of taking it. However, this should improve or stop completely after a few months as your body gets used to the medication. If bleeding doesn’t stop, speak to a doctor. If you are using sequential HRT patches, it is common to have a withdrawal bleed similar to a period.

    Can you swim with HRT patches?

    Yes, the patches are made to be waterproof and should withstand swimming. If your patch does come off during swimming, replace it with a new patch once you are out of the water and dry.

    Can you shower with HRT patches?

    Yes, the patches are made so you can bathe and shower while using them. If your patch does come off during your shower, replace it with a new patch once you are dry.

    Patient Reviews