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Everything you need to know about Evorel Sequi patches
Everything you need to know about Evorel Sequi patches
Evorel Sequi is a form of oestrogen and progestogen replacement therapy used as part of Hormone Replacement Therapy (HRT). It is a sequential HRT patch, meaning it provides oestrogen-only patches for part of the cycle, followed by combined oestrogen and progestogen patches. This mimics the natural menstrual cycle and is designed for women who are perimenopausal.
Medically reviewed by Dr. Liz Andrew
BMS Accredited Doctor
Reviewed: 20/02/2025 Published: 19/03/2025
The basics
Key Information About Evorel Sequi
Evorel Sequi contains estradiol (oestrogen) and norethisterone (progestogen). The patches follow a two-phase cycle:
- Evorel 50 (Weeks 1 & 2): Oestrogen-only patches that help replenish declining oestrogen levels.
- Evorel Conti (Weeks 3 & 4): Combined patches containing oestrogen and progestogen, which protect the uterine lining.
This cycle mimics the natural hormonal fluctuations of a menstrual cycle, making it suitable for women who are still having periods but are perimenopausal.
Evorel Sequi is a safe and effective form of HRT for many women. Since the hormones are absorbed through the skin, it bypasses the liver, which may reduce certain risks associated with oral HRT.
As with all HRT, the benefits and risks are individual and should be discussed with your doctor. Your medical history will determine whether Evorel Sequi is the right option for you.
The estradiol in Evorel Sequi is body identical, meaning it has the same chemical structure as the oestrogen naturally produced by the body. The progestogen (norethisterone) is synthetic but is included to protect the womb lining.
Most women using Evorel Sequi will have a withdrawal bleed (similar to a period) during week 4 of the cycle when using the Evorel Conti patches. If bleeding is heavy or prolonged, speak to your doctor.
When stopping HRT, symptoms may return, and some women experience withdrawal effects such as headaches, mood changes, or joint stiffness. Your doctor may suggest tapering off gradually rather than stopping suddenly, this can help reduce side effects as the changes in hormones are less sudden.
- If you are still having periods, start on day 1 of your natural cycle (first day of your period).
- If your periods are irregular, speak to your doctor about the best time to start.
HRT is not designed for period control, but if you need to delay a withdrawal bleed, speak to your doctor. They may advise adjusting the timing of your patches or considering an alternative regimen.
Yes, Evorel Sequi is designed for women who are still having periods but are experiencing perimenopausal symptoms. It provides a structured hormonal cycle similar to your natural one.
Patches should be changed twice a week. A common schedule is Monday & Thursday or Tuesday & Friday. It can help to set a reminder on your phone to change your patches.
Benefits of Evorel Sequi
The Estradiol in evorel sequi patches can help to:
- Relieve any of the 40 menopause symptoms you might have by replacing your natural oestrogen
- Supports bone health – reduces the risk of osteoporosis
- Provides a steady release of oestrogen – helping to maintain stable hormone levels
- Bypasses digestion – making it a gentler option for those who experience stomach issues with oral HRT
- Lower risk of blood clots – compared to oral oestrogen (tablets)
The progestogen as part of the combined patches helps protect the lining of the womb.
You should expect to see improvements in symptoms within the first three months. If you experience some benefits but not significant relief, your doctor may adjust your dose at your three-month review.
If you haven’t noticed any improvements after three months, there may be an issue with how your body absorbs the oestrogen. Your doctor may suggest a blood test to check your oestrogen levels.
Evorel Sequi explained
Dr. Laura Cawley and Dr. Liz Andrew explain combined patches on one of our latest webinars all about HRT and testosterone products. You can watch the fully recorded webinar on YouTube.
Learn more about your treatment options
Book a complementary discovery call with our patient expert Jane James. Jane can help you by:
- Explaining the clinical pathway and how oestrogen patches can be prescribed through Menopause Care
- Offering guidance as to whether you may benefit from hormone replacement therapy (HRT)
- Share personal insight and other patient experiences of oestrogen treatment (non-clinical advice)
- Offering compassionate support and a safe, confidential space to openly discuss your concerns
Side effects of Evorel Sequi
Common side effects:
- Skin irritation where the patch is applied
- Breast tenderness or pain
- Bloating
- Abdominal discomfort
- Headaches
- Mood changes
When stopping HRT, symptoms may return, and some women experience withdrawal effects such as headaches, mood changes, or joint stiffness. Your doctor may suggest tapering off gradually rather than stopping suddenly, this can help reduce side effects as the changes in hormones are less sudden.
If your side effects are impacting your quality of life, or they have not settled at three months, please speak to a doctor. If your side effects are severe, or you are concerned, you should speak to a doctor.
- If you are still having periods, start on day 1 of your natural cycle (first day of your period).
- If your periods are irregular, speak to your doctor about the best time to start.
If your symptoms persist despite using Evorel Sequi, you should see your menopause care doctor. Your doctor can advise you on whether to:
- Increasing your dose (switching to a higher-dose HRT)
- Add extra oestrogen (e.g., gel or spray)
- Switching to a different HRT regimen
You should always check with your doctor before changing the type, dose or form of HRT you are using.
4 tips to help you
How and Where to Apply Evorel Sequi
- 1
Apply directly to the skin
Replace the patch twice per week.
- 2
Apply to the lower abdomen or buttocks
IT is important to place the patch below the waist
- 3
Avoid areas of irritated skin or tight clothing
Do not apply creams or gels before the patch, as this can affect its adhesion
- 4
Change where you put the patch
Rotating the application site prevents skin irritation
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