Continuous combined HRT tablets are taken every day without a break. Patches are changed twice a week.
Always follow the instructions from a pharmacist or GP, or the leaflet in the medicine packet.
Dosage
Continuous combined HRT tablets contain an oestrogen called estradiol and a progestogen. The doses of oestrogen and progestogen in your HRT will depend on the brand.
How to take continuous combined HRT tablets
The tablets include the brands:
- Femoston-conti
- Kliogest
- Activelle
- Angeliq
Take continuous combined HRT tablets once a day. It's best to take them at the same time each day.
Swallow the tablet whole with a drink of water. Check your medicine packet to see if you need to take it with food.
Take your tablet without a break between packs. It can take up to 3 months for HRT to improve your symptoms.
How to use continuous combined HRT patches
The patches include the brand Evorel Conti.
Stick the patch onto a clean, dry, hairless and cool area of skin below your waist, such as on your thigh or bum. Do not apply the patch on the same area of skin twice in a row.
Do not put the patch:
- near your breasts
- on top of cuts, spots or irritated skin
- under elasticated or tight areas of clothing
- on creases or folds in your skin
- on your skin if you have recently used cream, talcum powder or moisturiser
- on skin exposed to direct sunlight
Wait at least 1 hour after putting the patch on before you try any activity or exercise that will make you sweat. This can affect how the patch sticks to your skin.
Change the patch twice a week. Try to do this on the same day or days every week. This may mean that 1 patch is on for 3 days and the next patch for 4 days. For example, if you put on a patch on a Monday, change it on Thursday, and again on the following Monday.
Your patch should stay on while bathing, showering, exercising or swimming. But if it does fall off, dry your skin and cool down before putting on a new one.
The patch should be covered from sunlight. When swimming, the patch can be worn under your bathing suit.
If your patch falls off or you need to replace it during the week, put the new patch in a different place.
Changing from another type of HRT
If you're switching to patches from another type of HRT, when to start your patches will depend on which medicine you're switching from.
You can start to use your patches straight away if:
- your periods have stopped and you have not been taking HRT
- you're switching from another type of continuous combined HRT
If you have been using sequential combined HRT, wait until the end of the cycle of your current medicine before using your new patches.
How long to take it for
It's common to take HRT for between 2 and 5 years to treat menopause symptoms. But sometimes you may need to take it for longer.
How long you take HRT for depends on the benefits and risks to you. Ask your GP for advice.
You'll usually be advised to take HRT at least until you're age 51 (the average age of menopause) if you have:
- premature menopause (where your periods stop before age 40)
- early menopause (where your periods stop before age 45)
If you have a hysterectomy to remove your womb, you'll need to stop taking combined HRT. You may be able to take oestrogen-only HRT instead.
If you forget to take it
If you forget to take your continuous combined HRT tablet, take it as soon as you remember, unless it's less than 12 hours until your next dose. In this case, skip the forgotten dose and take the next dose at the usual time. You may have some vaginal bleeding or spotting.
Do not take 2 doses to make up for a missed dose.
If you forget to change your HRT patch, change it as soon as you remember and apply the next one at the usual time. You may have some vaginal bleeding or spotting.
If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicines.
If you take too much
Taking an extra dose of continuous combined HRT is unlikely to harm you.
You may:
- feel sick (nausea), or be sick (vomit)
- have tender or painful breasts
- feel dizzy or drowsy (tired)
- have stomach pain
- have unexpected vaginal bleeding or spotting
If you're worried, talk to your GP or pharmacist for advice.
Stopping continuous combined HRT
Talk to your GP if you're thinking of stopping taking continuous combined HRT. They may suggest that you reduce your dose gradually to help prevent your menopause symptoms coming back.
If you're having problems with side effects, your GP might suggest changing your dose, or switching to another type of HRT.
If you have surgery
If you are going to have surgery, tell the surgeon that you are taking continuous combined HRT. You will be advised to stop taking your HRT tablets about 4 to 6 weeks before the surgery to reduce the risk of a blood clot.
Ask your GP or surgeon when you can start using HRT again.
Alcohol and HRT
You can drink alcohol while taking HRT. But it may be helpful to cut down on caffeine and alcohol during menopause as it can reduce symptoms of flushing and improve your sleep.
Food and HRT
You can eat and drink normally while taking continuous combined HRT. Try to have a healthy diet, as this can help with menopause symptoms and keep you well.