Evorel Patches (25, 50, 75 & 100)

What are Evorel patches and what are they used for?

Evorel HRT patches are a type of hormone replacement therapy (HRT) used to treat symptoms of menopause.

Evorel HRT patches:

• Gradually release hormones into the body — perfect if you have difficulty swallowing tablets, or if you have trouble remembering to take a tablet every day.
• Only need to be replaced twice per week.
• Contain estradiol, which emulates the female sex hormone oestrogen.
• Are available in four different strengths: 25mcg, 50mcg, 75mcg and 100mcg.
• Provide relief from menopausal symptoms within a few weeks of daily use.

As your body adjusts to Evorel, you may notice breakthrough bleeding or spotting. Talk to your GP if this continues after more than a few months of treatment. HRT should only be necessary as a relatively short-term treatment as your body adjusts to menopause. You should review your HRT with your GP at least once each year and have regular gynaecological checkups.

HRT will not prevent pregnancy in women who are otherwise fertile. Women under 50 are considered fertile until two years after their final menstrual cycle (for women over 50, this is reduced to one year). Do not use a hormonal contraceptive while undergoing HRT.

How does HRT work?

During menopause, the production of oestrogen in a woman’s ovaries gradually stops. This deficiency can lead to a number of symptoms, including hot flushes, depression, sleep problems, dryness and osteoporosis. If these symptoms are sufficiently severe, you may be prescribed Evorel in order to supplement the body’s oestrogen levels. Evorel should only be used to treat osteoporosis if other treatments have already been tried.

If you have had a hysterectomy (an operation to remove the uterus), oestrogen is the only hormone you will be required to replace. If you have not had your uterus removed, you will be prescribed a progestogen medicine alongside Evorel. This is because when oestrogen levels alone are increased, the lining of the uterus (the endometrium) will grow excessively. This will substantially increase your risk of complications such as endometrial cancer. If you have not had a hysterectomy, you may instead be prescribed another medicine that provides combined HRT.

What is the menopause?

All women go through menopause. This usually occurs between the ages of 45 and 55. As you approach this age, your ovaries will produce less and less oestrogen. This has the effect of stopping the menstrual cycle, but the change in hormone levels can lead to several symptoms which may have a substantial impact on day-to-day life.

Physical symptoms include:

• Hot flushes (a spontaneous heat that spreads throughout the body, leading to blushing, sweating and an unusually strong heartbeat)
• Night sweats
• Dryness of the eyes or vagina

The hormonal change can also cause distressing psychological effects such as irritability, insomnia and depression.

Experiences with menopausal symptoms vary significantly depending on the individual. They can begin multiple years prior to the menopause itself and remain for many years. Women will, on average, experience symptoms for about four years.

Non-medicinal alternatives for the symptoms of menopause

For Night Sweats and Hot Flushes

• Using a fan
• Cool showers
• Wearing light clothing

Vaginal Dryness

• Lubricants

Other Alternatives

• A healthy diet and regular exercise
• Stopping smoking

Sources

• Evorel Patches, Patient Information Leaflet: https://www.medicines.org.uk/e...
• https://patient.info/medicine/oestrogen-hrt-estradiol
• https://www.nhs.uk/conditions/menopause/symptoms/

Evorel directions

Apply the patch to an area of skin which is dry and clean. Press down firmly to ensure that the patch is in place. Many women choose to place the patch on the thighs or bottom. Each patch contains enough medicine for three to four days, so it must be changed twice each week. This should be done on the same two days each week. Do not place the new patch on the exact same section of skin. Do not leave an interval between each patch.

Evorel should not be used on or around the breasts, or under elasticated parts of clothing.

Evorel ingredients

The active ingredient contained in Evorel is estradiol.

Evorel also contains the following inactive ingredients to make up the complete product:

Duro-Tak 387-2287, guar gum, hostaphan MN19.

Evorel side effects

Not everyone will experience side effects when they take Evorel, however if you do they may include:

Itchy or inflamed skin where the treatment is applied, dizziness, breast pain, mood swings, nausea, stomach pain, headache, diarrhoea, joint pain, breakthrough bleeding, weight gain

If you are concerned about these effects, or if the product affects you in any other way, stop using it and talk to your doctor or pharmacist.

Evorel warnings

Reading the following warnings carefully will help to ensure you are selecting an appropriate product.

Evorel is unsuitable for you if you:

• Have ever had breast cancer
• May have a cancer which is sensitive to oestrogen (including uterine cancer)
• Have untreated endometrial hyperplasia (an excessively thick womb lining)
• Suffer from a blood clotting disorder, or have ever had a blood clot
• Have unexplained vaginal bleeding
• Have a history of heart attack or stroke
• Suffer from porphyria (a rare hereditary blood disease)
• Are allergic to any of the ingredients in the patch.

Inform your GP if you plan on using Evorel and have ever had any of the following health complications:

• Fibroids
• Impaired liver function
• Uterine problems including endometriosis or endometrial hyperplasia
• Circulation problems (e.g. angina, heart attack)
• High risk of blood clots
• Kidney disease
• Diabetes
• Migraine
• Gallstones
• Systemic lupus erythematosus
• Asthma
• Epilepsy
• Fluid retention
• High blood pressure
• High fat levels in the blood
• Otosclerosis (a hereditary ear disorder)
• A family history of breast cancer or another oestrogen-sensitive cancer
• A history of severe allergic reactions.

Tell your GP or pharmacist if you have taken or plan to take any of the following medicines:

• Epilepsy medicines (e.g. phenytoin, carbamazepine)
• Tuberculosis medicines (e.g. rifampicin)
• HIV medicines (e.g. nevirapine, ritonavir, nelfinavir)
• Bosentan (to reduce blood pressure in the lungs)
• St John’s Wort.

HRT may increase your risk of breast cancer. The extent of this risk will vary depending on the length of your HRT treatment and whether you are taking combined or oestrogen-only HRT. Check your breasts regularly for changes to the skin or nipple, or for any noticeable lump. For women who use HRT for more than five years, there may also be a slight increase in the risk of ovarian cancer.

Women over the age of 65 who use Evorel may have a slightly increased risk of developing dementia.

Stop using Evorel and seek medical attention immediately if you notice early signs of any of the following:

• Blood clots – pain and swelling of the legs, difficulty breathing
• Stroke – sudden migraines, blurred vision
• Heart disease – chest pain which extends to the neck or arm
• Liver disease – yellow colouration of the skin or eyes.

Discuss with your doctor whether your personal benefits of HRT outweigh the risks mentioned above.

Please read all packaging and the Product Information Leaflet before taking any new medicine and inform your doctor of medicines you are taking or intend to take.