Evorel

Evorel is a transdermal hormone replacement therapy (HRT) patch. It delivers oestradiol — the same oestrogen the ovaries produce — through the skin and into the bloodstream. It's prescribed to manage menopausal symptoms such as hot flushes, night sweats, sleep disturbance, mood changes, and vaginal dryness, and in some cases to help protect against osteoporosis in women at increased risk of fracture.

The patch sticks to the skin and releases a steady, low dose of oestradiol over three to four days. Because the hormone is absorbed through the skin rather than swallowed, it bypasses the liver on first pass, which is one of the reasons transdermal HRT is generally associated with a lower risk of blood clots than oral tablets.

The numbers (25, 50, 75, 100) refer to the daily dose of oestradiol in micrograms — clinicians usually start with the lowest effective strength and titrate upwards based on symptom control. Evorel Conti and Evorel Sequi are combined patches: as well as oestrogen, they also contain a progestogen (norethisterone), which is needed for women with a uterus to protect the womb lining. Conti is a continuous combined patch (no monthly bleed expected once settled) and Sequi is a sequential regimen (a planned monthly bleed).

Stick the patch onto clean, dry, intact skin below the waist — the buttocks, hip, or lower back are common sites. Avoid the breasts, the waistband area where clothing might rub it off, and any broken, irritated, or recently moisturised skin. Press firmly for around ten seconds and rotate the site each time so the same patch of skin doesn't get repeated exposure.

Each patch is designed to deliver hormone for three to four days, which is why it's changed twice weekly on the same two days each week (for example, Monday and Thursday). If you forget, change it as soon as you remember and resume your normal schedule. A single late change is unlikely to cause problems, but repeatedly missed changes can lead to symptoms returning or breakthrough bleeding.

If it comes off within the first day or two, try sticking it back on; if it won't adhere, apply a fresh patch and continue your normal change-day schedule. Patches occasionally lift at the edges after very hot showers, saunas, or vigorous exercise, so press firmly around the rim if you notice this.

Yes. Evorel is designed to stay on through bathing, swimming, and exercise. Very hot baths or saunas can loosen the adhesive, so it's worth checking the patch afterwards and pressing it back down if needed.

Hot flushes and night sweats often start to improve within a week or two, but the full effect on mood, sleep, and energy can take up to three months as your body settles. Vaginal symptoms may take longer and sometimes need an additional local oestrogen alongside.

Skin irritation at the patch site is the most common — redness, itching, or a small rash. Other reported effects include breast tenderness, headaches, nausea, and breakthrough bleeding, particularly in the first few months. Most ease as your body adjusts. Any sudden severe headache, chest pain, leg swelling, breathlessness, or visual disturbance is a red flag — seek urgent medical advice.

Transdermal HRT is often preferred for women with risk factors for blood clots, migraine, or certain liver and gallbladder conditions, because the hormone bypasses first-pass liver metabolism. It can also be a better option for women who have trouble remembering daily tablets or who experience nausea with oral oestrogen.

Yes. If you're using an oestrogen-only Evorel patch (25, 50, 75, or 100) and still have a uterus, you'll need a separate progestogen — usually as a Mirena coil, micronised progesterone capsule, or the combined Evorel Conti or Sequi patch — to protect the womb lining from overgrowth.

HRT isn't suitable for everyone. It's generally avoided in women with current or recent breast cancer, certain other hormone-sensitive cancers, undiagnosed vaginal bleeding, active liver disease, a history of blood clots in the legs or lungs, recent stroke or heart attack, or some inherited clotting disorders. A clinician will go through your full medical history before prescribing.