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Sequential combined hormone replacement therapy (HRT) is a medicine that contains the hormones oestrogen and progestogen. It's used to treat symptoms of menopause.

A GP will usually recommend sequential combined HRT if either:

  • you have menopause symptoms but you're still having periods
  • your last period was less than 12 months ago

Sequential combined HRT is only available on prescription. It comes as tablets.

Brands include Femoston, Novofem and Trisequens tablets.

Uses of sequential combined HRT

As you reach the menopause your ovaries gradually begin to produce less oestrogen and progestogen.

This can cause symptoms such as:

  • hot flushes
  • mood swings
  • vaginal dryness

Taking HRT can help these symptoms and help prevent other conditions such as weakening of the bones (osteoporosis), which is common after the menopause.

Sequential combined HRT involves taking oestrogen every day and taking progestogen for 10 to 14 days of each 28-day cycle. You'll usually have withdrawal bleeding at the end of each course of progestogen.

Information:

If you have not had a period for 1 year or more your GP may prescribe continuous combined HRT instead. This is where you take both oestrogen and progestogen every day with no monthly bleeding.

You'll need to take combined HRT if you still have a womb. This is because taking oestrogen on its own can thicken the womb lining, which slightly increases the risk of womb cancer. Taking progestogen together with oestrogen reduces the risk.

Page last reviewed: 1 June 2025
Next review due: 1 June 2028