If you’re starting Evorel Conti, you may have questions about how to use it and what to expect. This guide explains your treatment, how to use it safely, and when to speak to your clinical team.
What you need to know
Evorel Conti is a continuous combined hormone replacement therapy (HRT); treatment that replaces hormones that fall during menopause. Each patch releases both estradiol (an oestrogen) and norethisterone acetate (a progestogen, which protects your womb lining) through your skin.
This guide covers Evorel Conti patches. Change your patch twice a week. This treatment is intended to avoid a regular monthly bleed, although spotting or irregular bleeding can happen while your body adjusts.
Always follow your prescription and read the patient information leaflet supplied with your treatment.
What’s in your treatment?
Evorel Conti is a form of continuous combined HRT delivered as a transdermal patch. Each patch contains both estradiol (50mcg/day) and a progestogen, norethisterone acetate (170mcg/day), which is steadily released through the skin (transdermal route) into your bloodstream over several days.
What is it used for?
Evorel Conti is used for the relief of oestrogen deficiency symptoms in women after menopause (at least 6-18 months since their last period). It is also licensed for the prevention of osteoporosis (weakened bones that are more likely to break) in women after menopause at high risk of fractures.
How long does it take to work?
You may notice an improvement in symptoms within a few weeks, but it can take up to three months to adjust and feel the full benefit. Speak to your clinical team if symptoms aren’t improving.
How to use your treatment
One patch should be applied to a clean, dry, and non-irritated area of skin on your lower abdomen or trunk, below the waistline. Do not apply it to your breasts or near your waistline where tight clothing might rub it off.
When and how to change a patch: Each patch is worn continuously and replaced twice a week (every 3 to four days). To help you remember, it is best to change your patch on the same two days each week, for example, every Monday and Thursday.
When you apply a new patch, choose a different spot of skin. You should wait at least one week before applying a patch to the same site again.
Evorel Conti should remain in place during bathing and showering. Should a patch fall off during bathing or showering, you should wait until you’re dry and your body temperature returns to normal before applying a replacement patch to avoid potential excessive absorption of HRT.
Should a patch fall off at other times, it should be replaced immediately, but you should stick to your original change days.
You can use baby oil to help remove any gum/glue which may remain on the skin after patch removal.
If you are switching from a cyclical HRT preparation, you should start treatment with Evorel Conti at the end of your scheduled bleed.
If you miss a dose
If you forget to change a patch, you should change it as soon as possible and apply the next one at the normal time on your original change days. However, if it is almost time for the next patch, you should skip the missed one and go back to your regular schedule. Only one patch should be applied at a time. There is an increased likelihood of unexpected bleeding and spotting when a patch is not replaced at the normal time. Always follow your prescribed instructions and check with your clinical team if you’re unsure.
Your dose and treatment plan
Therapy usually begins with one standard dose patch. Treatment is usually started with the lowest effective dose and can be adjusted by your clinician after a few months depending on your response with the dose increased or decreased as necessary. Your clinician will aim to use the lowest effective dose for the shortest time needed to manage your symptoms, with regular reviews.
There are no special dosage requirements for older patients, although experience in treating women over 65 is limited. This medicine is not for use in children.
Contraception, pregnancy, and breastfeeding
This treatment isn’t contraception. You may still need contraception, including if it’s been less than 12 months since your last period or you’re under 50. Ask your clinical team for advice tailored to you.
If you become pregnant, stop treatment immediately and contact your clinician. This treatment isn’t indicated during breastfeeding.
Other important safety information
This is a "bleed-free" form of HRT, but irregular bleeding or spotting is common in the first 3-six months. If this continues beyond six months, you should see your clinician to discuss.
Side effects and treatment risks
The most common side effect is a reaction at the application site, such as redness or itching. Other potential side effects include headaches, breast pain, and mood changes. As a transdermal form of HRT, Evorel Conti bypasses the liver and carries a lower risk of blood clots (venous thromboembolism) compared to other systemic forms of HRT, such as oral tablets or capsules. The other risks associated with systemic HRT, such as a small increased risk of breast cancer and stroke, still apply, although the overall risk remains low for most patients being treated. For a full list of side effects, please see the Patient Information Leaflet provided with your medication.
Reviews and ongoing clinical support
Your clinician will review your treatment after three months, then at least once a year. They’ll check your symptoms, side effects, any vaginal bleeding, your weight, and your blood pressure, and decide whether further tests are needed.
Examine your breasts regularly and attend routine screening appointments, including mammograms and cervical screening where appropriate. If you had menopause earlier than expected, discuss how this may affect the benefits and risks of HRT with your clinician.
When to stop treatment and seek medical help
Stop using Evorel Conti and seek urgent medical advice if you develop:
Signs of a blood clot, such as painful swelling in a leg.
Swelling of your face, tongue, or throat, difficulty swallowing, or hives with difficulty breathing — possible signs of a severe allergic reaction.
Yellowing of your skin or eyes (jaundice).
A significant increase in your blood pressure.
A new migraine-type headache.
Pregnancy.
If you have difficulty breathing or another life-threatening symptom, call 999. Don’t wait for an email response.
For planned changes or stopping treatment, speak to your clinician. They may recommend reducing your dose gradually to help prevent menopausal symptoms from returning suddenly.
Conditions that need closer monitoring
Tell your clinical team if you have any of the following conditions, have had them before, or they worsened during pregnancy or previous hormone treatment. You may need closer monitoring because they can return or worsen during treatment.
Fibroids (non-cancerous growths in the womb) or endometriosis (tissue similar to the womb lining growing outside the womb)
A history of, or risk factors for, blood clots
Risk factors for tumours affected by oestrogen, such as breast cancer in a close relative
High blood pressure
Liver conditions, including non-cancerous liver tumours
Diabetes, with or without blood vessel complications
Gallstones
Migraine or (severe) headache
Lupus (an immune-system condition).
A history of thickening of the womb lining
Epilepsy
Asthma
Otosclerosis (a condition affecting the bones in the ear)
Hereditary angioedema (an inherited condition causing episodes of swelling)
Mastopathy (changes affecting breast tissue)
How to store your treatment
Store at room temperature, at or below 25°C, within the original sachet and box. Keep out of reach of children, including used and disposed patches.
When to speak to your clinical team
Contact your clinical team if you have questions about your prescribed schedule, side effects, symptoms that aren’t improving, or bleeding that concerns you. For non-urgent questions or to discuss your clinical plan, email [email protected].
Frequently asked questions
Will I have a monthly bleed?
Evorel Conti is designed to be a bleed-free treatment, but irregular bleeding or spotting can happen during the first three to six months. Speak to your clinician if it continues beyond six months or concerns you.
Can I change my dose myself?
No. Follow your prescription and speak to your clinical team before changing your dose or treatment schedule.
Is this treatment contraception?
No. Ask your clinical team whether you still need contraception and which options are suitable for you.
Lastly, please read the Patient Information Leaflet linked below and included with your treatment for a full list of side effects, contraindications, and precautions.