Evorel Conti

Evorel Conti is a continuous combined hormone replacement therapy (HRT) patch containing estradiol and norethisterone acetate.

It is prescribed for postmenopausal women who are at least 12 months past their last menstrual period, to relieve menopausal symptoms and to prevent postmenopausal osteoporosis.

The estradiol component replaces the declining oestrogen that characterises the menopause, relieving vasomotor symptoms such as hot flushes and night sweats, as well as urogenital symptoms including vaginal dryness and discomfort.

Norethisterone acetate, a progestogen, is included to protect the endometrium from the stimulatory effect of unopposed oestrogen, thereby reducing the risk of endometrial hyperplasia and cancer.

As a transdermal patch, Evorel Conti delivers hormones through the skin directly into the bloodstream, bypassing first-pass hepatic metabolism.

This route avoids the effects on hepatic protein synthesis seen with oral HRT and may be associated with a lower risk of venous thromboembolism compared with oral preparations, though the evidence is not conclusive.

Evorel Conti is a continuous combined product, meaning both hormones are delivered simultaneously without a break.

Most women become period-free after the first few months of use, although some irregular spotting may occur initially.

Apply one patch to a clean, dry, and hairless area of skin on the lower abdomen or buttock. Press firmly in place for about 10 seconds.

Change the patch every three to four days (twice weekly), and use a slightly different site each time to minimise skin irritation.

Do not apply the patch to the breasts or to areas where it may be rubbed off by tight clothing. If a patch falls off, apply a new one and change it on the next scheduled day.

Bathing, swimming, and exercise are usually fine while wearing the patch.

Treatment should be reviewed at least annually with your prescriber to assess whether the benefits still outweigh the risks.

One Evorel Conti patch applied twice weekly (every 3 to 4 days), providing continuous delivery of estradiol 50 micrograms and norethisterone acetate 170 micrograms per 24 hours.

The patch is supplied in a single strength. If symptom control is inadequate, your prescriber may consider an alternative preparation or a separate estradiol patch with adjusted progestogen.

The lowest effective dose for the shortest duration should be used.

Application site reactions such as redness, itching, and mild irritation occur in approximately 10 to 20 per cent of users. These are usually mild and resolve by rotating the patch site.

Breast tenderness, headache, nausea, and bloating are commonly reported, particularly during the first few months of therapy.

Irregular vaginal bleeding or spotting may occur initially but usually settles within three to six months.

Weight fluctuations, mood changes, and leg cramps have been noted.

Serious but uncommon risks include venous thromboembolism, stroke, and a small increase in the risk of breast cancer with long-term use (over five years).

The thrombotic risk may be lower with transdermal HRT than with oral formulations.

Rarely, gallbladder disease, liver dysfunction, or exacerbation of migraine may occur.

All forms of HRT carry a small increased risk of breast cancer and venous thromboembolism.

Attend regular breast screening and report any new breast lumps, skin changes, or nipple discharge to your doctor.

Seek urgent medical help if you develop sudden chest pain, leg swelling, breathlessness, or severe headache.

Evorel Conti should not be started if you are still having periods. It is intended only for women who have been postmenopausal for at least 12 months.

Using it earlier may increase the risk of irregular bleeding.

Inform your prescriber of your full medical history, including any personal or family history of breast cancer, blood clots, liver disease, or cardiovascular events.

Evorel Conti is contraindicated in women with known or suspected breast cancer, other oestrogen-dependent malignancies, undiagnosed vaginal bleeding, untreated endometrial hyperplasia, active or previous venous thromboembolism, active arterial thromboembolic disease, acute liver disease, and known hypersensitivity to any component of the patch.

It should not be used during pregnancy or breastfeeding, or in women with a history of porphyria.