When starting HRT for the first time, your doctor might advise you to start it at the beginning of a menstrual cycle, if you're still having periods.
Follow the instructions on the pack, and read the leaflet about how to take it.
Dosage
Sequential combined HRT is taken in 28-day cycles. This means that you take oestrogen every day, but you only take it with progestogen for 10 to 14 days of your cycle. You then repeat the cycle without a break.
You'll usually have withdrawal bleeding at the end of each course of progestogen.
The tablets and patches come in different strengths. Your doctor will prescribe the right dose for you, depending on your symptoms, your age and any other health conditions you have.
Changes to your dose
You'll usually start on a low dose, and it may be increased later, depending on how well it works and whether you get any side effects.
If you're having side effects from taking HRT and think you may need to change your dose, speak to your doctor.
How to take it
How to take sequential combined HRT tablets
You take sequential combined HRT tablets every day without a break.
Try to take them at around the same time each day.
You can take them with or without food.
Each pack contains 2 or 3 different types of tablets, in different colours. It's important to follow the instructions on the pack and in the leaflet to make sure you take them on the correct days.
How to use sequential combined HRT patches
You put sequential combined HRT patches on your skin, and change them once or twice a week, depending on which type of patch you have.
Each pack contains 2 different types of patch, containing either oestrogen only, or oestrogen and progestogen. It's important to follow the instructions on the pack and in the leaflet to make sure you use the patches on the correct days.
Put the patch on skin below your waist, such as your buttocks, hips or thighs. Do not put them near your breasts.
Put them on skin that is clean, dry and healthy.
Each time you change your patch, put the new one in a different place below your waist.
You can leave the patch on while you have a bath or shower. If it falls off, wait until your skin has cooled down, then put on another patch. If a patch falls off early for any other reason, put a new patch on straight away. Then continue to change the patches on the usual day.
How long to take or use it for
It's common to take or use HRT for between 2 and 5 years to treat menopause symptoms, but sometimes you may need to take it for longer. How long you take it 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 years old. This 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 or use it
If you forget to take your sequential combined HRT tablet, 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're using patches and forget to change it, change it as soon as you remember and then change it again on the usual day. 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 take too much
Taking an extra dose of HRT is unlikely to harm you.
If you take too many tablets, you may feel sick or be sick.
If you're worried, or have any unusual symptoms after taking too much HRT, talk to a doctor or pharmacist for advice.
Stopping sequential combined HRT
Talk to your doctor if you're thinking of stopping taking sequential combined HRT. They may suggest 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.