Who can and cannot take or use it - Sequential combined HRT

You can usually take sequential combined HRT if you're still having periods (perimenopausal) or had your last period less than 1 year ago.

Sequential combined HRT is not suitable if you've had a hysterectomy to remove your womb.

Who may not be able to take sequential combined HRT

Sequential combined HRT is not suitable for everyone.

To make sure it's safe for you, tell your doctor before taking it if you:

• have ever had an allergic reaction to any medicine containing oestrogen or progestogen, or anything contained in the patches or tablets
• have ever had breast cancer
• are having tests for breast cancer, or are considered high risk due to family history
• have ever had any other type of cancer
• have vaginal bleeding with no known cause
• have ever had a blood clot in a vein (thrombosis), such as in the legs (deep vein thrombosis) or the lungs (pulmonary embolism)
• have problems with your blood which may cause a blood clot
• have ever had angina or a heart attack
• have liver, heart or kidney problems
• are pregnant or breastfeeding
• have a rare inherited condition called porphyria
• have diabetes
• have high blood pressure
• have migraines or severe headaches
• have thickening of the lining of the womb (endometrial hyperplasia) that has not been treated, or fibroids or endometriosis
• have an underactive thyroid
• have lupus
• have epilepsy
• have asthma
• are living with obesity
• have dementia
• have gallstones
• have or ever had meningioma (a tumour of the layer between the brain and skull)
• have otosclerosis (a disease affecting the eardrum and hearing)
• have a very high level of triglycerides (type of fat) in your blood

If you get any of these conditions after you start taking sequential combined HRT, stop taking it and talk to your GP.

Sequential combined HRT and pregnancy

Do not take sequential combined HRT if you're pregnant or might become pregnant.

If you get pregnant while taking sequential combined HRT then stop taking it and talk to your GP immediately.

Sequential combined HRT is not known to be harmful in pregnancy. But levels of oestrogen and progesterone are naturally high during pregnancy, so you will not need HRT.

Sequential combined HRT and breastfeeding

You should not take sequential combined HRT if you are breastfeeding.

Talk to your GP about alternatives. There is not enough information for us to know if sequential combined HRT is safe while breastfeeding.

Sequential combined HRT and fertility

Sequential combined HRT contains both oestrogen and progesterone. But it is not the same as the combined oral contraceptive pill - it does not act as a contraceptive.

Even if you think you have gone through the menopause, there may be a small chance that you could become pregnant.

It's recommended to use contraception for:

• at least 1 year from your last period - if you're over age 50
• 2 years - if you're under age 50

Talk to your GP if you have concerns.