Evorel Sequi patches
Sequential hormone replacement therapy (HRT) patches containing estradiol and norethisterone for the relief of menopausal symptoms.
Prices from £33.97
In stock. Simply fill in a brief questionnaire. One of our doctors will review your order and prescribe a suitable treatment. How to Order
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Evorel Sequi patches are a hormone replacement therapy (HRT) medication containing artificial versions of the female hormones oestrogen (estradiol) and progesterone (norethisterone). These patches deliver hormones through the skin to relieve menopausal symptoms.
Evorel Sequi is known as ‘continuous sequential’ HRT. This means it follows a 28-day hormone cycle, similar to a woman's natural hormone cycle. For the first 2 weeks, you’ll use Evorel 50 patches, which contain 3.2mg of estradiol. Then, you’ll use Evorel Conti patches for the last 2 weeks, which contain 3.2mg of estradiol and 11.2mg of norethisterone.
Evorel Sequi is suitable for perimenopausal and postmenopausal women with a womb. The patches are applied directly to the skin and changed twice a week.
About Evorel Sequi patches
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Evorel Sequi patches are a type of hormone replacement therapy (HRT) for people with menopause symptoms who still have a womb. They are a combination of 2 different patches:
- Evorel 50 (oestrogen patches). These contain the active ingredient estradiol and help to replace your naturally declining oestrogen levels during menopause, which is what causes symptoms like mood changes, night sweats, and hot flushes.
- Evorel Conti (oestrogen and progesterone patches). These contain estradiol and norethisterone and maintain your oestrogen levels while also raising your progesterone levels, which causes your womb lining to shed.
You’ll take Evorel 50 for 2 weeks, then Evorel Conti for the following 2 weeks before starting this cycle again. This is called sequential HRT, and is usually recommended if you still have periods or they have just stopped.
Taking progesterone only for the final half of the 28-day cycle causes your womb lining to shed. This means you’ll have a withdrawal bleed, like a period, in week 4. This helps regulate bleeding if you’re having irregular periods, and also reduces the risk of your womb lining building up, which decreases the risk of endometrial cancer.
Evorel Sequi can also be used to prevent osteoporosis in those at high risk when other medications have not worked.
What’s the difference between Evorel Sequi and Evorel Conti?
Evorel Sequi is a sequential HRT, which means you’ll take oestrogen for half of the 28-day cycle before adding in progesterone. Evorel Conti is a continuous HRT which does not follow a 28-day cycle. Instead, you’ll always take oestrogen and progesterone.
Evorel Sequi is recommended if you’re still having periods, or if your periods have just stopped. Evorel Conti can be used if you no longer have periods. This is because taking progesterone continuously while you are still having periods may cause heavier, longer, or irregular bleeding.
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Evorel Sequi patches work by replacing the oestrogen that is normally released by the ovaries but naturally declines during menopause. Lower oestrogen levels are what cause menopause symptoms. However, taking oestrogen on its own regularly may cause the lining of your womb to build up and get thicker. This means progesterone is added in the last 2 weeks of your 28-day HRT cycle.
Progesterone helps shed the lining of the womb and stop any problems from happening, as a build-up of the womb lining can cause endometrial cancer. This will cause a ‘withdrawal bleed’ and is similar to having a period, but the bleeding may be lighter. You’ll usually get a withdrawal bleed during week 4 of your 28-day cycle.
How long does Evorel Sequi last?
Evorel Sequi patches last for 3 to 4 days. This means you’ll need to apply a new one twice weekly. It will continue to work as long as you take it and you do not take any breaks between patches.
How long does Evorel Sequi take to work?
In clinical trials, people reported relief from menopause symptoms in a few weeks after starting Evorel Sequi.
How effective is Evorel Sequi?
One clinical trial studied how a low-dose combination of estradiol and norethisterone can reduce menopausal symptoms like hot flushes. The findings are in this table:
Week 1 Week 12 Week 52 Number of mild hot flushes reported 16 5 4 Number of moderate hot flushes reported 19 3 2 Number of severe hot flushes reported 11 1 1 Evorel Sequi can also be beneficial for osteoporosis, a common condition in menopausal women. Osteoporosis can cause weakened bones and fractures, while declining oestrogen levels also reduce your bone density, making osteoporosis more likely. The 2 different types of patches in Evorel Sequi can improve bone density and reduce the risk of fractures.
After 2 years of taking Evorel 50 (oestrogen) patches:
- 84% of people maintained or gained bone density in their spine
- 93% of people maintained or gained bone density in their hips
After 2 years of taking Evorel Conti (oestrogen and progesterone) patches:
- 90% of people maintained or gained bone density in their spine
- 74% of people maintained or gained bone density in their hips
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One Evorel Sequi patch is applied twice a week. They are taken in a specific order so that you have a withdrawal bleed around week 4 of your 28-day cycle:
Weeks 1 and 2 (days 1 to 14) Weeks 3 and 4 (days 15 to 28) You should use 4 x Evorel 50 patches in total, applying 1 at a time. Each patch lasts either 3 or 4 days.
Choose a patch change day and change your patch on the same 2 days every week. For example, if you apply your first patch on a Tuesday, change it on Friday. Then your patch change days will always be Tuesday and Friday.
Set a reminder on your phone or use a calendar to keep track of your patch change days.
You should use 4 x Evorel Conti patches in total, applying 1 at a time. Each patch lasts either 3 or 4 days.
As soon as it’s patch change day on your final Evorel 50 patch, swap it with an Evorel Conti patch. Continue with the same patch change days.
At the end of the 28-day cycle, start a new pack of Evorel Sequi straight away.
Do not leave a break between patches.
To apply Evorel Sequi patches, follow these steps:
- Choose a clean, hairless area of skin for your patch. The most common areas to apply Evorel Sequi are the thighs or bottom.
- Check you have the correct patch. For example, if you’re just starting Evorel Sequi, you should apply Evorel 50 first.
- Each patch is inside a protective pouch. Do not use it if it’s open or looks damaged. Tear along the edges of the pouch to remove the patch.
- Face the protective backing towards you. Bend and peel away half of the backing, avoiding contact with the sticky side of the patch. If you touch it, it may not stick as well.
- Apply the sticky part of the patch to your chosen area of skin.
- Remove the rest of the protective backing and carefully stick the rest of the patch down.
- Gently press down on the patch with the palm of your hand for at least 10 seconds. The pressure and warmth from your hand will help the patch stick well, so there’s less chance it will fall off. If you tend to have cold hands, it can help to warm them up with warm water before starting this process.
If you need to remove a patch to apply a fresh one:
- Peel an edge of the patch away and slowly remove it from the skin.
- Fold the patch in half so that the sticky side (where the medication was being released into your skin) sticks to itself.
- Throw it away. Avoid flushing it down the toilet.
- It’s normal for some glue to still be on your skin after removing a patch. It will go away on its own or after a shower, but it can also be removed with baby oil.
When to apply Evorel Sequi
Apply Evorel Sequi twice weekly. Choose your patch change days and then stick to this schedule. For example, if you apply your first patch on:
- Monday, change on Thursday, then the following Monday and so on
- Tuesday, change on Friday, then the following Tuesday and so on
Your Evorel Sequi pack comes with the different patch change days printed on it, so you can mark them on your pack to help you remember. It does not matter what time you apply Evorel Sequi, but try to stick to the same schedule for each patch change.
Where should I apply Evorel Sequi?
Evorel Sequi should be applied to clean, hairless skin. The best areas to apply it are your bottom or thigh, but make sure to use a new area for each patch, so that you are rotating around the skin. Do not apply a new patch in the same place as the patch you just removed.
Do not apply Evorel Sequi on:
- or near your breasts
- broken or irritated skin, or on spots
- top of moisturiser or talc
- a part of the skin which could be affected by a waistband or tight clothing
How long do you need to take Evorel Sequi for
You can take Evorel Sequi for as long as you need it for your menopause symptoms, as long as it remains effective and suitable for you. Usually, people take HRT for around 2 to 5 years, but your doctor will check in with you regularly to see if you still need it.
What should I do if a patch falls off?
Apply a new patch as soon as you can, but still stick to your usual patch change days. It’s a good idea to carry a spare patch with you. You can still shower, exercise, go swimming, and sunbathe, but there are some things you can do to reduce the chances of your patch coming off, such as:
- applying the patch to clean, dry skin, not skin that has been moisturised or is still damp from the shower
- not scrubbing the patch when you shower
- avoiding tight clothing or waistbands where your patch is
- keeping the patch covered from sunlight, especially if sunbathing
What happens if I forget to change my patch?
If you forget to change your patch, change it as soon as you remember. Stick to your usual patch change days. You may get some bleeding or spotting.
What if I take more Evorel Sequi than I should?
It’s unlikely that you will have any symptoms if you take too much Evorel Sequi. The patches only release a small amount of hormones each day, and the medication in the patches runs out even if you forgot to take an old patch off. However, symptoms of too much oestrogen and progesterone include:
- sore breasts
- feeling or being sick (nausea or vomiting)
- unexpected vaginal bleeding
- acne
- tiredness
- low mood
- body or facial hair growth
If you think you’ve taken too much Evorel Sequi, speak to your doctor.
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Evorel Sequi can cause some side effects, though these will not happen to everyone. Your doctor will monitor your progress and make sure you’re only using HRT for the shortest amount of time needed, and that the benefits outweigh the risk of side effects.
Very common side effects (affect more than 1 in 10 people) include:
- itchy, irritated, rash, or red skin where the patch is applied
Common side effects (affect less than 1 in 10 people) include:
- water retention (oedema), which can cause a build-up of fluid under the skin
- heavy or painful periods
- weight gain
- breast pain
- feeling generally unwell
- pain in the back, muscles, or joints
- diarrhoea
- nausea, stomach pains, wind
- itchy skin or rash
- headache
- being unable to sleep
- changes in mood and emotion, including feeling depressed or nervous
Uncommon side effects (affect less than 1 in 100 people) include:
- problems concentrating
- dizziness
- change in sex drive (libido)
- thrush
- tiredness
- allergic reaction (hypersensitivity)
- heart palpitations
- lumps in the breast that are not cancerous
- fuller breasts
- irregular bleeding
- numbness or tingling in the hands or feet, reduced skin sensitivity
- thickening of the lining of the womb
Other side effects that have been reported, but not enough to estimate how often they happen, include:
- puffy skin where the patch is applied
- mood swings
- feeling bloated
- gallstones
- oedema in the hands and feet
Evorel Sequi may cause some serious side effects. Make sure to speak to a doctor or call 999 in an emergency straight away if you get or suspect any of the following:
- seizures (fits)
- Stevens-Johnson syndrome, which causes a widespread rash with peeling skin and blistering of the eyes, mouth, and genitals
- breast, ovarian, or endometrial cancer, or hyperplasia (long, heavy, or irregular vaginal bleeding)
- high blood pressure (uncommon), symptoms may include headache, tiredness, or dizziness
- migraines that happen for the first time, or get worse (uncommon)
- liver problems, such as jaundice, which causes yellowing of the skin and the whites of the eyes
- blood clots (rare), which can cause symptoms like a swollen, painful or hot limb (affecting 1 leg or arm), sudden chest pain, or difficulty breathing
- stroke
- severe allergic reaction, which can cause breathing difficulties, swelling in the face and throat, and rash
For more information on side effects, please read the patient information leaflet carefully before starting your medication.
How long do Evorel Sequi side effects last?
Most Evorel Sequi side effects will happen when you first start treatment and get better as your body gets used to the medication, within a few weeks to a few months. However, serious side effects can develop at any time.
What to do if you get Evorel Sequi side effects
Always report any Evorel Sequi side effects to your doctor and keep a note of them to see if they get better or go away on their own. Any serious side effects should be reported to a doctor straight away, or you or someone else should call 999 in an emergency, such as if you suspect a blood clot or have a serious allergic reaction.
There are some things you can do at home that may help with Evorel Sequi side effects, such as:
- applying the patch on a new area of skin each week, and to different areas to see what works best for you to reduce patch reactions
- taking over-the-counter painkillers to help manage headaches or pain
- staying hydrated
- eating well and gentle exercise to help with weight gain, sleeping well, and stomach problems
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HRT can slightly increase your risk of certain diseases, including:
- breast cancer
- endometrial hyperplasia (abnormal growth of the lining of the womb) or cancer of the lining of the womb
- ovarian cancer
- blood clots
- probable memory loss if started over the age of 65
- heart attack
- stroke
Because of this, your doctor will check your medical history carefully before prescribing.
You will not be able to use Evorel Sequi if you have:
- a history of breast cancer or currently have breast cancer
- any cancer affected by oestrogen, such as cancer of the womb lining
- unexplained vaginal bleeding
- endometrial hyperplasia that is not being treated
- a history of blood clots, a blood clotting disorder, or recently had a disease caused by blood clots in the arteries, such as a heart attack, stroke, or angina
- a liver disease, or you had one but your liver tests have not returned to normal
- porphyria, a rare, inherited blood problem
- an allergy to any ingredients in the patches, including the active ingredients
Tell your doctor if you have any other conditions, as you may need extra monitoring while you take Evorel Sequi, such as:
- epilepsy
- fibroids inside your womb
- high blood pressure
- thyroid problems
- a liver disorder, such as a benign liver tumour
- asthma
- family history of an oestrogen-sensitive cancer
- migraine or severe headaches
- diabetes
- fluid retention caused by heart or kidney problems
- a disease affecting the eardrum and hearing (otosclerosis)
- growth of the womb lining outside your womb (endometriosis)
- a history of endometrial hyperplasia
- angioedema
- a very high level of fat in your blood (triglycerides)
- increased risk of developing blood clots
- a disease of the immune system that affects many organs of the body (systemic lupus erythematosus)
- gallstones
- history of severe allergic reactions
- cramps
Let your doctor know if you are due to have surgery, as you will need to stop Evorel Sequi 4 to 6 weeks before. Evorel Sequi may also affect the results of some urine or blood tests.
HRT and cancer
Endometrial cancer
Taking oestrogen increases the risk of thickening of the lining of the womb, which can cause endometrial hyperplasia and cancer. Evorel Sequi also contains progesterone, so that you will have monthly bleeds, which protects you from this extra risk. However, speak to your doctor straight away if you get unexpected bleeding or spotting that:
- continues for more than 6 months
- starts after taking Evorel Sequi for more than 6 months
- continues after you stop taking Evorel Sequi
Breast cancer
HRT can slightly increase your risk of breast cancer. For example, in women aged 50 taking combined HRT like Evorel Sequi for 5 years, there are an extra 4 to 8 cases reported compared to women not taking HRT. After stopping Evorel Sequi, the extra risk of breast cancer will decrease, but this can take 10 years or more if you take HRT for at least 5 years.
While taking Evorel Sequi, it’s important to:
- go for regular breast screening and cervical smear tests
- regularly check your breasts for any changes, such as dimpling of the skin, nipple changes, or any lumps
Ovarian cancer
Ovarian cancer is much rarer than breast cancer, but HRT can very slightly increase the risk of getting it. For example, in women taking HRT for 5 years, there is an extra 1 case reported compared to women not taking HRT.
HRT and blood clots
The risk of blood clots is about 1.3 to 3 times higher than in people not taking HRT, especially in the first year of using it. For example, in women aged 50 taking HRT for 5 years, there are an extra 5 cases of blood clots reported compared to women not taking it.
Let your doctor know if you:
- are taking medication containing oestrogen
- are very overweight (a body mass index of above 30)
- have had a miscarriage
- are unable to walk for a long time because of major surgery, injury, or illness
- have cancer
- have any blood clotting problem that needs treatment
- have a rare illness called systemic lupus erythematosus
- or any of your close relatives has ever had a blood clot
- are going on a long journey and will not be moving about for some time, such as a long plane ride
As these all increase your risk of blood clots, Evorel Sequi may not be suitable.
Other medication and Evorel Sequi
Let your doctor know if you take any other medications, herbal remedies, or over-the-counter treatments before starting Evorel Sequi, especially:
- medication for hepatitis C
- herbal remedies containing St John’s Wort
- medication for epilepsy, such as phenobarbital, phenytoin, or carbamazepine
- certain medication for tuberculosis, such as rifampicin or rifabutin
- lamotrigine for epilepsy, as this could increase the frequency of seizures
- bosentan, for high blood pressure in the blood vessels of the lungs
- medication used to treat HIV, such as nevirapine, efavirenz, ritonavir, or nelfinavir
Evorel Sequi in pregnancy and breastfeeding
Do not use Evorel Sequi if you are pregnant or think you might be. If you’re still having periods while taking Evorel Sequi and there’s a chance of pregnancy, you should use a form of contraception. Evorel Sequi is not contraception.
Evorel Sequi is not suitable if you are breastfeeding.
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You can get Evorel Sequi patches prescribed from a doctor, either online from regulated services like Asda Online Doctor, or from your GP. You cannot get Evorel Sequi over the counter, it’s a prescription-only medication.
Can I buy Evorel Sequi online?
Yes, Evorel Sequi is available from Asda Online Doctor with a prescription from one of our doctors. To get Evorel Sequi through our HRT service, follow these simple steps:
- Complete a medical questionnaire – Share your medical history and symptoms using a quick online assessment.
- Doctor review – A registered doctor will review your answers and confirm if Evorel Sequi is suitable. If they believe another HRT treatment is more suitable, they will let you know through your online account.
- Fast delivery or collection – Get your chosen HRT delivered to your home for free, or collect from a local Asda Pharmacy.
- Ongoing care – You and your doctor can message for free, through your online account, for follow-up advice or support.
Can I buy Evorel Sequi over the counter?
No, HRT is not available over the counter as it needs to be prescribed by a doctor, and you need to be monitored during treatment.
Can I get Evorel Sequi on the NHS?
Yes, you can get Evorel Sequi or a generic alternative on the NHS. Menopause treatment is available from your GP after a consultation.
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There are lots of menopause treatments available, including HRT and non-hormonal options, depending on your symptoms, medical history, and preferences. Alternative menopause treatments offered at Asda Online Doctor include:
Treatment type Medications and active ingredients Can help with: Combination HRT patches containing an oestrogen and progesterone Evorel Conti – contains estradiol and norethisterone
Estradot Conti – contains estradiol and norethisterone in 2 different doses: 30 micrograms (mcg)/95mcg or 40mcg/130mcg
All menopause symptoms – is recommended if you no longer have periods HRT treatments containing patches and tablets Estradot 50 patches (estradiol) with Utrogestan tablets (progesterone) – can be taken continuously if you no longer have periods, or sequentially if you still have periods
Evorel patches and Utrogestan tablets (sequential) – contains estradiol in the patches and progesterone in the tablets
Estraderm MX patches and Utrogestan (sequential) – contains estradiol in the patches and progesterone in the tablets
All menopause symptoms Combination HRT tablets containing an oestrogen and progesterone Elleste Duet Conti – contains estradiol and norethisterone
Kliovance – contains estradiol and norethisterone
Tibolone – contains the active ingredient tibolone which is broken down into oestrogen and progesterone by your body
Kliofem – contains estradiol and norethisterone
Femoston-conti – contains estradiol and dydrogesterone
All menopause symptoms HRT vaginal creams, gels, and tablets containing oestrogen Ovestin cream – contains estriol
Vagifem tablets – contains estradiol
Estriol cream – contains estriol
Vagirux tablets – contains estradiol
Oestrogel – contains estradiol
Vaginal menopause symptoms like dryness, painful sex, and irritation as they are inserted directly into the vagina Non-HRT treatments Veoza – contains fezolinetant, a medication that works on the part of your brain responsible for body temperature Hot flushes and night sweats Evorel Sequi vs Estradot
Evorel Sequi is a type of combined, sequential HRT patch. Estradot is an oestrogen-only HRT patch, which can be taken with pills containing progesterone such as Utrogestan. Estradot can be used as part of a continuous HRT or sequential regimen.
You can also take Estradot patches on their own if you do not have a womb, as progesterone is only needed to prevent the womb lining from thickening.
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Does Evorel Sequi cause weight gain?
A common side effect reported on Evorel Sequi is weight gain. However, there is not enough evidence to prove that HRT itself causes weight gain. It’s more likely a combination of fluid retention and the menopause itself. Menopause can cause weight gain because your hormone cycles are disrupted, causing a slower metabolism and a higher chance of fat storage in the abdomen.
Is Evorel Sequi a contraceptive?
No, Evorel Sequi is not a contraceptive, and you can still get pregnant if you are having periods. It’s important to use another form of contraception, like condoms, until you stop having periods. You should not use Evorel Sequi with other contraceptives containing hormones.
Can I cut the patch in half if I want a lower dose?
No, you should not cut your Evorel Sequi patches in half. They may not work or stick properly, so you may not be getting the right dose. This can make the patches less effective. If you are getting side effects or think you need a lower dose, speak to your doctor. They may be able to recommend another treatment.
Can I drink alcohol while using Evorel Sequi?
Yes, you can drink alcohol while using Evorel Sequi. Although it does not interact with the medication, be careful about drinking if you have side effects like stomach discomfort, nausea, vomiting, or headaches. Alcohol can make these side effects worse, so it’s better to wait until they have passed. Alcohol also contains a lot of calories, so it can increase weight gain.
Brenda studied medicine at St Georges University of London and has most recently worked in John Radcliffe Oxford University Hospitals, covering acute and general medicine.
Meet our doctorsLast reviewed: 28 Jul 2026
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Evorel Sequi (PIL), emc [accessed 23 March 2026]
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How and when to take or use sequential combined hormone replacement therapy (HRT), NHS [accessed 23 March 2026]
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Ultra-low-dose estradiol and norethisterone acetate: bleeding patterns and other outcomes over 52 weeks of therapy, Climacteric [accessed 23 March 2026]
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Weight gain and hormone replacement therapy: are women's fears justified?, Maturitas [accessed 23 March 2026]
GMC: 7074021
GMC: 6149065
GMC: 7085115
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