If you’re still having periods, your GP may suggest starting HRT at the beginning of your menstrual cycle.
Follow the instructions on the pack, and read the leaflet about how to take it.
It can take up to 3 months for HRT to improve your symptoms.
Dosage
Sequential combined HRT is taken in 28-day cycles. This means that you take oestrogen every day, but you only take it with progestogen for 10 to 14 days of your cycle. You then repeat the cycle without a break.
You'll usually have withdrawal bleeding at the end of each course of progestogen.
The medicines come in different strengths.
Your GP will prescribe the right dose for you, depending on:
- your symptoms
- your age
- any other health conditions you have
Changes to your dose
You'll usually start on a low dose. It may be increased later, depending on how well it works and if you get any side effects.
If you're having side effects from taking HRT and think you may need to change your dose, talk to your GP.
How to take sequential combined HRT tablets
You take sequential combined HRT tablets every day without a break.
Try to take them at around the same time each day.
You can take them with or without food.
Each pack contains 2 or 3 different types of tablets, in different colours. It's important to follow the instructions on the pack and in the leaflet to make sure you take them on the correct days.
How to use sequential combined HRT patches
You put sequential combined HRT patches on your skin, and change them twice a week.
Each pack contains 2 different types of patch, containing either:
- oestrogen only
- oestrogen and progestogen
It's important to follow the instructions on the pack and in the leaflet to make sure you use the patches on the correct days.
Put the patch on skin below your waist, such as your bum, hips or thighs. Do not put them near your breasts.
Put them on skin that is clean, dry and healthy.
Each time you change your patch, put the new one in a different place below your waist.
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
How long to take or use it for
It's common to take or use 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 it 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 or use it
If you forget to take your sequential 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're using patches and forget to change it, change it as soon as you remember. Then change it again on the usual day. If it's almost time for the next patch, skip the missed one, and then change the patch on the usual day. You may have some vaginal bleeding or spotting.
If you take too much
Taking an extra dose of 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 sequential combined HRT
Talk to your GP if you're thinking of stopping taking sequential combined HRT. They may suggest you reduce your dose gradually. This is 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 using HRT and what type you are using.
You will usually need to stop taking tablets about six weeks before the operation to reduce the risk of a blood clot.
If you are only taking patches, you generally do not need to stop HRT before surgery. But it's important to check this with your surgeon beforehand.
You can ask your GP or surgeon when it's OK for you to restart your HRT after your operation.
Alcohol and HRT
You can drink alcohol while taking HRT. But it may be helpful to cut down on alcohol during the menopause. This can help to reduce symptoms of flushing and improve your sleep.
Food and HRT
You can eat and drink normally while taking sequential combined HRT. Try to have a healthy diet, as this can help with menopause symptoms. Cutting down on caffeine may help to reduce hot flushes and improve your sleep.