Evorel Sequi Patches

Description

Hormone Replacement Therapy (HRT) plays a vital role in managing the physical and emotional challenges that many women face during menopause. One widely prescribed option is Evorel Sequi®, a transdermal patch treatment that delivers a combination of estradiol (as hemihydrate) and norethisterone acetate through the skin. Unlike traditional oral medications, patches bypass the digestive system, ensuring a steady release of hormones directly into the bloodstream.

This comprehensive guide explores what Evorel Sequi is, how it works, its clinical benefits, safety considerations, possible side effects, and practical advice on usage. Drawing from the official package leaflet and supplemented by current clinical evidence, this blog post serves as an authoritative reference for patients, healthcare providers, and anyone researching modern HRT solutions.

1. What is Evorel Sequi?

Evorel Sequi is a combined sequential HRT patch designed specifically for women experiencing menopausal symptoms due to declining estrogen levels. It is primarily prescribed for:

• Relief of menopausal symptoms such as hot flushes, night sweats, mood swings, vaginal dryness, and reduced bone density.
• Prevention of osteoporosis in postmenopausal women who are at higher risk of bone fractures.

The Hormonal Components

• Estradiol (as hemihydrate): This is a synthetic form of estrogen identical to the natural hormone produced by the ovaries before menopause.
• Norethisterone acetate: A synthetic progestogen that mimics the effects of progesterone, ensuring that the endometrium (lining of the womb) does not thicken excessively due to estrogen therapy.

By combining these hormones, Evorel Sequi provides a balanced, sequential regimen that helps manage symptoms while protecting long-term uterine health.

2. How the Evorel Sequi System Works

Unlike single-phase patches, Evorel Sequi uses a memory pack system containing eight patches:

• Four Evorel 50 patches (CE50): These release estradiol only.
• Four Evorel Conti patches (CEN1): These release estradiol combined with norethisterone.

This two-phase cycle mimics the body’s natural hormonal rhythm:

1. First 2 weeks: Estradiol-only patches (to replenish estrogen).
2. Next 2 weeks: Estradiol + norethisterone patches (to add progestogen protection).

The cycle then repeats, ensuring continuous symptom relief while minimizing risks like endometrial hyperplasia.

3. Clinical Benefits of Evorel Sequi

Relief from Menopausal Symptoms

Evorel Sequi is effective in reducing:

• Hot flushes and night sweats
• Vaginal dryness and discomfort during intercourse
• Mood swings and sleep disturbances
• Loss of skin elasticity and hair thinning

Bone Health and Osteoporosis Prevention

Estrogen plays a key role in maintaining bone density. After menopause, bone loss accelerates, increasing the risk of fractures. Studies show that transdermal estradiol helps reduce bone turnover and supports bone strength.

Cardiovascular and Metabolic Considerations

Transdermal HRT, unlike oral HRT, avoids “first-pass metabolism” in the liver. This may reduce risks of clotting and triglyceride elevation compared to oral estrogen, making it a preferable option for some women.

4. Safety Considerations Before Using Evorel Sequi

Not every patient is an ideal candidate for HRT. It’s crucial to review medical history before starting treatment.

Do Not Use If You Have:

• A history of breast cancer or estrogen-sensitive cancers
• Unexplained vaginal bleeding
• Untreated endometrial hyperplasia
• Previous or current blood clots (DVT or pulmonary embolism)
• Severe liver disease
• Untreated high blood pressure
• Allergy to estradiol, norethisterone, or patch adhesives

Medical Supervision Required If You Have:

• A family history of breast cancer
• Fibroids or endometriosis
• High blood pressure or elevated cholesterol
• Diabetes
• Gallbladder disease
• Epilepsy, asthma, or migraines

5. How to Use Evorel Sequi Correctly

Each memory pack contains 8 patches to be used over a 28-day cycle:

1. Weeks 1–2: Apply one Evorel 50 (estradiol-only) patch twice weekly.
2. Weeks 3–4: Apply one Evorel Conti (estradiol + norethisterone) patch twice weekly.

Application Instructions

• Apply to clean, dry, hairless skin on the buttocks, lower abdomen, or outer thigh.
• Do not apply to the breasts.
• Rotate patch sites to avoid skin irritation.
• Change patches every 3–4 days, on the same two days each week.
• If a patch falls off, replace it with a new one immediately.

6. Possible Side Effects

Like all medicines, Evorel Sequi may cause side effects.

Common Side Effects

• Breast tenderness or swelling
• Headaches and migraines
• Skin irritation at patch site
• Bloating or nausea
• Mood changes

Less Common but Serious Risks

• Increased risk of breast and endometrial cancer with prolonged use
• Blood clots (though lower risk with patches than with oral HRT)
• Stroke or heart disease in high-risk women

Monitoring and Reporting

Patients should attend regular check-ups and mammograms. Any unusual bleeding, breast changes, or persistent headaches should be reported to a doctor immediately.

7. Clinical Evidence and Research Insights

Transdermal vs. Oral HRT

Several studies confirm that transdermal estradiol patches like Evorel Sequi are associated with:

• Lower risk of venous thromboembolism (VTE) compared to oral estrogen.
• More stable hormone levels, reducing mood fluctuations.
• Improved adherence thanks to twice-weekly application.

Cancer Risk Mitigation

Adding progestogen (norethisterone) significantly lowers the risk of endometrial hyperplasia and cancer compared to estrogen-only HRT.

8. Storage and Handling

• Store below 25°C.
• Do not refrigerate or freeze.
• Keep patches in their protective sachets until use.
• Dispose of used patches safely, folding sticky sides together.

9. Patient FAQs

Q: How soon will I notice improvements?
A: Many women experience symptom relief within a few weeks, though full benefits may take 3 months.

Q: Can I use Evorel Sequi if I still have periods?
A: Yes, but it should be started at the correct stage of your cycle as advised by a doctor.

Q: Can Evorel Sequi help with weight management?
A: It is not a weight-loss medication. However, stabilizing hormones may help reduce bloating and improve sleep, indirectly supporting weight balance.

10. Practical Lifestyle Tips for Women on Evorel Sequi

• Maintain a balanced diet rich in calcium and vitamin D.
• Engage in weight-bearing exercises like walking or yoga.
• Avoid smoking and limit alcohol intake.
• Manage stress through mindfulness or relaxation therapies.
• Keep a symptom diary to track improvements and side effects.

11. Long-Term Considerations

HRT is typically prescribed at the lowest effective dose for the shortest duration. Some women may need it for only a few years, while others may benefit from longer use under strict medical supervision.

12. Final Thoughts

Evorel Sequi patches offer a clinically proven, patient-friendly solution for managing menopause symptoms and protecting bone health. By delivering hormones directly through the skin, they provide consistent relief with fewer metabolic complications compared to oral therapies.

While HRT is not without risks, the benefits often outweigh the drawbacks for many women struggling with severe symptoms. Careful medical screening, regular follow-ups, and informed lifestyle choices can maximize the advantages while minimizing side effects.

13. Disclaimer

This article is for educational purposes only and does not replace professional medical advice. Always consult a qualified healthcare provider before starting, changing, or stopping any medication.