How does sequential combined HRT work?
As you approach the menopause, levels of the sex hormones oestrogen and progesterone fall, which causes symptoms such as hot flushes, night sweats, mood swings and vaginal dryness.
Sequential combined HRT works by replacing these hormones, which helps to improve menopause symptoms.
When will I feel better?
It can take up to 3 months for hormone replacement therapy (HRT) to work fully to improve your symptoms.
There are different types of HRT, and it can take time to find the type and dose that works for you.
If you do not feel better after 3 months, speak to your doctor. They may suggest changing your dose, or switching to a different type of HRT.
Are there any long-term side effects?
It's best to only take HRT at the lowest dose that works for you, and only for as long as you need it to control your menopause symptoms.
This is because HRT can slightly increase the risk of breast cancer and blood clots. The risk is small, but it increases the longer you take HRT.
Usually, the risk is outweighed by the benefits of HRT, such as improving menopause symptoms, quality of life and preventing osteoporosis. But this depends on your age, symptoms and health. Speak to your doctor, who can help you decide.
How does it compare with other types of HRT?
There are several different types of HRT. They all work equally well to replace the hormones that fall during and after the menopause.
No one type of HRT is suitable for everyone. You may need to try different types to find what works best for you.
It's better to take or use sequential combined HRT if you're still having periods (perimenopause). You'll normally have withdrawal bleeding at the end of each course of progestogen.
Once your periods have stopped, you'll usually be advised to switch to continuous combined HRT, where you take both oestrogen and progestogen every day, without a monthly bleed.
Sequential combined HRT contains an oestrogen and a progestogen to protect your womb. If you've had a hysterectomy to remove your womb, you'll be advised to take oestrogen-only HRT.
Your doctor can help you decide on the type of HRT that's best for you.
How does it compare with alternatives to HRT?
HRT such as sequential combined HRT is usually the most effective treatment for menopause symptoms.
If you cannot take HRT, or prefer not to take it, your doctor may be able to recommend other medicines or lifestyle changes to help with your symptoms.
Medicines such as clonidine and some antidepressants (such as fluoxetine or sertraline) are sometimes used as an alternative to HRT to help with symptoms such as hot flushes, night sweats and mood swings.
What will happen if I stop taking it?
If you stop taking HRT your menopause symptoms might come back.
If you're taking it for osteoporosis there is a chance that your bones will get weaker and you may be more likely to have fractures in the future.
Talk to your doctor if you're thinking of stopping. They'll help you decide what's best for you. They may suggest that you reduce your dose gradually, to help stop 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.
Can I switch to a different brand?
There are different brands and types of sequential combined HRT. A pharmacist or doctor can advise on which type would be suitable. It will depend on whether you prefer to take tablets or use patches, and what dose you need.
If the brand or type of HRT that you've been using is not available because of supply shortages, is not helping your symptoms, or if you have problems with side effects, a doctor or pharmacist can advise about switching to a different type.
Can I get HRT for free?
You'll need to pay for your hormone replacement therapy (HRT) prescriptions unless you're eligible for free prescriptions. When there is more than one type of patch or tablet in the same box, you will need to pay a charge for each.
However, you can reduce the cost by getting an HRT pre-payment certificate (PPC). This means you can pay a small fee that will cover all your HRT prescriptions for a year.
Find out how to save money with a prescription prepayment certificate.
Will I gain or lose weight?
There's no good evidence that sequential combined HRT makes you put on weight.
However, it's common to gain weight around the time of the menopause. Eating a balanced diet and exercising regularly will help you keep to a healthy weight.
Will it affect my contraception?
Sequential combined HRT is not a contraceptive.
It's still possible to get pregnant while taking HRT, so you'll need to use contraception until 2 years after your last period if you're under 50 years old, or for 1 year if you're over 50 years old.
You'll need to use a non-hormonal method of contraception such as condoms or a diaphragm, or other options which you can speak to your doctor about.
Can I drive or ride a bike?
Yes. Sequential combined HRT does not affect your ability to drive or ride a bike.
Can I drink alcohol while taking sequential combined HRT?
You can drink alcohol while taking HRT but it may be helpful to cut down on alcohol during the menopause to reduce symptoms of flushing, and improve your sleep.
Is there any food or drink I need to avoid?
You can eat and drink normally while taking sequential combined HRT.
Try to have a healthy diet, as this can help with menopause symptoms and keep you well.
Cutting down on alcohol and caffeine may help reduce hot flushes and improve your sleep.
Can lifestyle changes help menopause symptoms?
The following lifestyle changes can sometimes help with menopause symptoms:
- Regular exercise. This helps with bone health and can reduce hot flushes and improve your sleep. It may also help improve your general mood, reduce stress and help you keep to a healthy weight.
- Cut down on caffeine and alcohol. This may help reduce hot flushes and improve your sleep.
- Quit smoking. This can help reduce hot flushes and reduce your risk of developing other health problems such as cancer, heart disease and stroke.
Find out more about lifestyle changes for menopause symptoms