How And When To Take Continuous Combined Hrt

NHS medicines information on dosage for continuous combined HRT, how to take it and what to do if you miss a dose or take too much.

Continuous combined HRT tablets and capsules are taken every day without a break. Patches are changed once or twice a week. Always follow the instructions from a pharmacist or doctor, or the leaflet in the medicine packet.

Dosage

Continuous combined HRT tablets and capsules contain an oestrogen called estradiol, and a progestogen. The doses of oestrogen and progestogen in your HRT will depend on the brand.

How to take or use it

How to take continuous combined HRT tablets and capsules

The tablets and capsules include the brands Elleste Duet Conti, Kliofem, Kliovance, Femoston-conti, Indivina and Bijuve.

Take continuous combined HRT tablets or capsules once a day. It's best to take them at the same time each day.

Swallow the tablet or capsule whole with a drink of water. Check your medicine packet to see if you need to take it with food.

Take your tablet or capsule without a break between packs.

How to use continuous combined HRT patches

The patches include the brands Evorel Conti and FemSeven Conti.

Stick the patch onto an area of skin below your waist, such as on your thigh or buttocks. Do not put the patch:

• near your breasts
• on top of cuts, spots or irritated skin
• under elasticated or tight areas of clothing
• on creases or folds in your skin
• on your skin if you have recently used cream, talc or moisturiser
• on skin exposed to direct sunlight

Wait at least 1 hour after putting the patch on before you try any activity or exercise that will make you sweat as this can affect how the patch sticks to your skin.

Change the patch once or twice a week (depending on the brand you use). Try to do this on the same day or days every week. This may mean that 1 patch is on for 3 days and the next patch for 4 days. For example, if you put on a patch on a Monday, change it on Thursday, and again on the following Monday.

Your patch should stay on while bathing or showering but if it does fall off, dry your skin and cool down before putting on a new one.

If your patch falls off or you need to replace it during the week, put the new patch in a different place.

Changing from another type of HRT

If you're switching to patches from another type of HRT, such as tablets, when to start your patches will depend on which medicine you're switching from.

You can start to use your patches straight away if:

• your periods have stopped and you have not been taking HRT
• you're switching from another type of continuous combined HRT

If you have been using sequential combined HRT (taking your progestogen only on some days, and having a break), wait until the end of the cycle of your current medicine before using your new patches.

How long to take it for

It's common to take HRT for between 2 and 5 years to treat menopause symptoms, but sometimes you may need to take it for longer. Talk to your GP about how long they recommend you take the treatment.

How long you take HRT for depends on the benefits and risks to you. Ask your doctor for advice.

If you have premature menopause (where your periods stop before the age of 40) or early menopause (where your periods stop before the age of 45), you'll usually be advised to take HRT at least until you're 51, which is the average age of menopause.

If you have a hysterectomy to remove your womb, you'll need to stop taking combined HRT. You may be able to take oestrogen-only HRT instead.

If you forget to take it

If you forget to take your continuous combined HRT tablet or capsule, take it as soon as you remember, unless it's less than 12 hours until your next dose. In this case, skip the forgotten dose and take the next dose at the usual time. You may have some vaginal bleeding or spotting.

Do not take 2 doses to make up for a missed dose.

If you forget to change your HRT patch, change it as soon as you remember and apply the next one at the usual time. If it's almost time for the next patch, skip the missed one and then change the patch on the usual day. You may have some vaginal bleeding or spotting.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicines.

If you take too much

Taking an extra dose of continuous combined HRT is unlikely to harm you. If you're worried, talk to a doctor or pharmacist for advice.

Stopping continuous combined HRT

Talk to your doctor if you're thinking of stopping taking continuous combined HRT. They may suggest that you reduce your dose gradually, to help prevent your menopause symptoms coming back.

If you're having problems with side effects, your doctor might suggest changing your dose, or switching to another type of HRT.

Find out more about when to take HRT and stopping taking it

If you want to find out more about this particular topic you can visit the Original article on the NHS website. If you are worried by any aspect of your health make sure you go and see your doctor or book an appointment at your local clinic.