HRT patches: Types, benefits and how to use them

At times, menopause can feel like a rollercoaster that you didn't ask to ride. It's a period of your life that is full of ups, downs and less-than-fun symptoms like mood changes, weight gain, brain fog, night sweats and more.

Luckily, modern medicine has given us a way to treat symptoms of menopause. It's called hormone replacement therapy, or HRT. HRT comes in many forms, including tablets, gels, sprays and sticky patches.

This article is your comprehensive guide to HRT patches. It covers everything from how they work to how to use them, the pros and cons, common side effects and when to seek medical advice (hint: right away). Plus, we share insider tips like where the best place on your lower body is to place a new patch.

What are HRT patches?

HRT stands for hormone replacement therapy. It is also known as menopausal hormone therapy (MHT) [5].

The purpose of HRT is to help relieve symptoms of menopause. It is a long-term treatment that many women will stay on for 2-5 years or more [1].

HRT patches are one type of treatment. They are small, sticky squares or rounds that you apply to your skin. Other forms of HRT include gels, sprays and tablets (we’ll talk about these later). 

How do HRT patches work? 

No matter which kind of HRT you choose to use, they all have the same goal – replacing the hormones which are lost during menopause [1]. The 2 main hormones being replaced are oestrogen and progestogen.

With HRT patches, your body absorbs these hormones through the skin. This sends them into the bloodstream so they can be carried around your body [5].

The different types of HRT patches

Like most treatments, HRT patches come with more than one formula that you could take. Your doctor will usually recommend a treatment based on individual factors – like the stage of menopause that you’re in or whether you’ve had a hysterectomy.

They’ll also look for the option that is most convenient for you. For example, you might find tablets hard to swallow, so a patch or gel will be easier.

Oestrogen-only patches

There’s nothing too mysterious about these patches; it’s in the name. As described, oestrogen-only patches contain 1 hormone.

They are usually recommended for women who have had a hysterectomy [1]. But they could also be used alongside a progestogen-only option for combined treatment.

Combined HRT patches (oestrogen and progestogen)

You’ve probably figured this one out from the title as well, but just to be clear – combined HRT patches contain both hormones [1].

This option is recommended for women who have not had a hysterectomy. This is because both hormones are needed to help protect your womb from risks of serious disease. 

Cyclical vs continuous patches

The last piece of the puzzle we want to explain is the way that you take your HRT treatment. There are 2 options: cyclical or continuous [1].

• Cyclical (sequential): Cyclical HRT is usually for women in perimenopause who are still having their period. It uses combined HRT on a monthly cycle. Your patches will release a steady dose of oestrogen daily and progestogen for the last 10-14 days of your cycle.
• Continuous: Continuous HRT is usually for post-menopausal women, who have not had a period for at least 1 year. It typically involves combined HRT where you take both hormones daily without a break.

HRT patches available in the UK

There are many different ways to take HRT in the UK, including patches. We can’t say which one will be recommended because it’s up to your doctor to decide which type of treatment works best for your body. 

What we can do is share a few of the most common patches in the UK, such as [7]:

• Combined patches: Evorel Sequi, Evorel Conti, Femseven Conti
• Oestrogen-only patches: Evorel, Estradot, Estraderm, Femseven Mono

If you’d like to know more about any of these options, the best place to start is a chat with your doctor. 

The pros and cons of HRT patches

Any medication for any condition around the world comes with an upside and a downside, and HRT patches are no different. To help build your knowledge, here are a few of the key benefits and potential disadvantages of HRT patches.

It’s also a good idea to chat with your doctor about the pros and cons before starting HRT. 

Key benefits

Patches are proving to be one of the most popular options to treat menopausal symptoms for a wide range of reasons, including [6]:

• They are easy to use and painless
• Unlike tablets, they avoid your digestive system, which can help minimise gut side effects
• You only need to change them 1-2 times per week, as opposed to a daily dose from other treatment options
• There are both high and low doses available
• Some research even suggests that HRT patches, gels and sprays are better than tablets for relieving sleep disturbances during menopause

Disadvantages to consider

HRT patches are actually pretty well tolerated, which means there aren’t too many downsides to think about.

A key one is that they are more likely to cause skin irritation than similar treatments in gel or spray form [6]. Experts think this is because the patches stay on your skin for days at a time, whereas a gel or spray is absorbed within minutes.

Research also suggests that hormone patches may be slightly less effective for women living with obesity. We don’t have direct research for HRT, but we do for birth control, which is a similar hormone-based treatment.

One study found that contraception patches were slightly less effective in women who weighed 90kg or more. That’s not to say they don’t work – just that they work differently. It's possible that the same will be true for HRT patches as well.

We hope you know that weight gain during menopause is normal and that support is available if you want to work toward a healthier weight. You could ask your doctor about a personalised weight loss plan or consider joining a holistic programme.

With the Juniper Programme, you can access weight loss medication tailored to your health and goals — never one-size-fits-all. Our app helps you track progress, connect with your care team, adjust medication as needed, and access expert support. You'll also get structured tools to build lasting habits and ongoing care. 

Kickstart your weight loss journey with Wegovy or Mounjaro, groundbreaking weight loss injections that mimic the GLP-1 hormone to help control cravings, delay stomach emptying, and keep you feeling fuller for longer.

We help you make lifestyle and habit changes, and we’re in it with you for the long run, having helped thousands of women achieve their weight loss goals.

How to use HRT patches

The best place to check how to use your specific HRT patches is the patient information leaflet that came with the medication. But we can give you some general tips that work for most patches [3][8]:

• Most patches are changed 1-2 times per week on the same days (e.g. every Monday and Thursday)
• Remember to remove your old patch before applying a new one, and apply to a different area of skin to help reduce irritation
• Apply the patch on clean, dry and cool skin
• Choose an area below your waist, such as the inner thigh or bottom
• Do not apply the patch anywhere near your breasts, on wounds or irritated skin, under tight clothing or on skin that will be exposed to direct sunlight
• To apply a patch, bend and peel away the protective backing
• With the sticky side facing your body, press the patch firmly onto your skin
• Hold your palm over the patch for at least 10 seconds to help warm it up, so that it sticks properly

How to stop your HRT patch from falling off

The main reason that a patch falls off is that it couldn’t stick to the skin properly. There are a few tips that can help stop this from happening [1][3][8]:

• Make sure to hold the patch down for at least 10 seconds during application
• Apply the patch to clean, dry skin
• Try not to touch the sticky side of the patch before you apply it
• Avoid moisturiser and powder right before you apply a patch as these can stop it from sticking
• Be gentle with your skin, especially in the area around the patch, as scrubbing could lift up the edges

What to do if you forget to change your HRT patch

Don’t worry – nothing happens if you forget to change a patch on time. It just means your next dose is a little late. Simply change your patch as soon as you remember [8].

If you forget for a long time and your hormone levels drop, you might experience some menopause symptoms. You might also have some breakthrough bleeding or spotting, though this is most likely for women who are still having periods.

Common side effects of HRT patches 

While HRT patches are pretty low on side effects, that’s not to say there are none. Most women will start on a low dose to help reduce side effects. Once their body is used to the medication, the dose can be increased [3]. 

Some of the mild side effects of HRT patches include [1][2]: 

• Headaches
• Breast pain or tenderness
• Skin irritation such as redness, dryness, a rash or itching
• Nausea
• Leg cramps
• Unexpected bleeding or spotting
• Diarrhoea
• Hair loss
• Mood changes

It can take a few months for side effects to settle down, so give your body time to adjust. It’s common to have a 3-month check with your doctor to help you keep track of and manage side effects [9].

You can also learn more about possible side effects in the patient information leaflet that came with your medication.

Serious side effects are rare, but it’s worth chatting to your doctor about these before you start a medication. For example, some HRT treatments can increase risks of serious disease.

How to manage HRT patch side effects

Your doctor or pharmacist is a good person to talk to about how to manage side effects [2]. Trust us when we say they’ve seen a lot of it before and will know what to do.

Some remedies will be simple. For example, patches can leave a mark on your skin after they are removed. Peeling the patch away slowly can help reduce marks [1].

Others might lead to a change in your dose or swapping to a different type of HRT. Your doctor will be able to help you decide if this is the best plan [9][10].

It can be helpful to keep a diary of your side effects to track whether they are settling down or not. Most side effects will stop after the first few months of treatment. If not, make sure to chat with your doctor. 

HRT patches vs tablets, gels and sprays

Earlier, we mentioned a few more types of HRT that you might hear about or be prescribed. All of these different types are effective, so choosing the right one comes down to what works best for you and your body [1].

We’ve spoken a lot about patches already, but to refresh your memory: these are applied to the skin and come in both combined and oestrogen-only options. They also have fewer gut side effects than oral HRT (tablets).

Tablets are one of the most common HRT medications. They are usually taken once per day and available in both combined and oestrogen-only options. Some of the downsides of tablets are that side effects can be worse than with skin-based HRT, and you do need to remember to use them daily.

Gels are an oestrogen-only option that you apply to the skin once per day. You might need to take a separate progesterone if you choose this option. It’s also important to let the gel soak fully into the skin (around 5 minutes) so that it doesn’t rub off when you get dressed.

Sprays are also an oestrogen-only option. Usually, you apply 1-3 sprays to your inner arm or thigh. These only take around 2 minutes to fully soak in, but you do need to avoid getting the area wet for at least 1 hour after applying.

When it comes to hormone replacement therapy (HRT), there are no bad treatment options. It’s about finding the one that is simplest and most effective for you.

Switching to another type of HRT 

Some women do find that HRT patches or another form is not working very well for them. Usually, they know this because they are still experiencing menopause symptoms [9].

When it comes to patches, the best absorption is actually from your bottom. So, if you’ve been using the inner thigh, you could try a new placement first.

If you prefer a skin-based HRT to tablets, then there are still gel and spray options to consider. But if you really want to stay on combined HRT, then tablets might be the best option [1].

Remember, your doctor is the only person who can prescribe a different type of HRT. So, if you’re thinking about switching – you know who to ask.

Who can and can't use HRT patches?

Whether you’re just reaching perimenopause or looking at life after menopause, HRT patches are safe for most women. Of course, there are always exceptions to the rule.

There are some women who should be more careful, such as [4]:

• Women who have had an allergic reaction to oestrogen
• Women with a family history or previous diagnosis of breast cancer
• Women who have any serious health condition, such as cancer, diabetes, high blood pressure, liver or heart disease
• Women who have had or are at risk of blood clots
• Women who have migraines or severe headaches
• Women who have experienced vaginal bleeding with no clear cause

Starting any type of HRT is going to come with a visit to your doctor, so rest assured you’ll be in safe hands. They’ll help you understand the different types available to you and whether any may not be suitable.

When to speak to your GP about HRT patches

We hope it’s clear by now that your doctor will be the first person that you speak to about anything to do with HRT patches – whether that’s starting HRT, side effects or changes.

When you first start or change HRT patches, your doctor should book in a 3-month review [9]. This helps make sure the treatment that you’re on is working well.

Even once you get settled on a medication, they’ll still recommend an annual review. This gives you the chance to chat about what’s working well, any side effects or concerns, and to look at the latest research in case something new is available to you [11].

If your primary GP has any concerns, they might also refer you to a specialist for more advice.

FAQs about HRT patches 

We’ve covered a lot so far, but we know there might still be a burning question on your mind. Here are short and sweet answers to some of the most common ones.

How long does an HRT patch last?

Most HRT patches need to be changed 1-2 times each week, which means each individual patch lasts for around 3-4 days [5][8].

Can you swim, shower or exercise with an HRT patch? 

Yes, you can do all of these! But there are some tips to keep your patch firmly stuck on [3][8]:

• Ideally, you’ll wait 1 hour before exercise because getting hot and sweaty can make your patch more likely to fall off
• As clean as you want to be, try not to scrub your patch too hard in the bath or shower, as this can loosen its edges
• If your patch does fall off after getting sweaty or wet, apply a new patch on clean and dry skin

Can you cut an HRT patch in half?

Healthcare professionals don’t recommend cutting patches in half because it can affect how the hormones are absorbed and whether they stay stuck to your skin [5].

We know there have been shortages of popular brands around the world, but we also know these don’t last forever. If your preferred brand of HRT patches is hard to find at the moment – chat to your doctor or pharmacist. They can help you with an alternative medication that is not in shortage.

What happens if your patch falls off?

Sometimes, even if you do everything right, a patch just doesn’t want to stay. If you notice your patch has fallen off – don’t panic. Nothing major happens, but you might have absorbed fewer hormones.

The best thing to do is apply a new patch as soon as you notice. You can also stick to your usual schedule for changing patches [3].

If you find a sticky residue leftover from your old patch, you can clean it up with a bit of baby oil.

Can you use HRT patches alongside vaginal HRT?

To give you some background, vaginal HRT is any of a cream, gel, tablet or ring that is inserted into your vagina [1].

It works best for local symptoms, like vaginal dryness or burning. It doesn’t always work for other common menopause symptoms like hot flushes or mood swings.

It would be unlikely that you’d use both vaginal HRT and patches because they both contain oestrogen. But the best person to ask for personalised advice is your doctor.

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