The Independent Pharmacy

Evorel Sequi Side Effects: Everything You Need To Know

Andy Boysan
Andy BoysanBPharmDirector & Superintendent Pharmacist

Reviewed on 2 Apr 2024

Symptoms of the menopause such as depression, irritability, hot flushes, vaginal dryness and loss of libido (just to name a few) can be extreme, upsetting, and disruptive to everyday life.

Fortunately, hormone replacement therapy (HRT) treats these unpleasant symptoms caused by the hormones that decrease during the menopause by supplementing them. Evorel Sequi is one such HRT which can effectively alleviate these menopausal symptoms. So what do you need to know about Evorel Sequi patches side effects?

In this guide, we look at these side effects in more detail, including rumoured Evorel Sequi weight gain and Evorel Sequi bleeding. Find out more here:

What is Evorel Sequi?

Evorel Sequi is a type of hormone replacement therapy (HRT) used to treat symptoms of the menopause. HRT is designed to replace the hormones oestrogen and progesterone that naturally decrease during the menopause.

Unlike most HRT treatments which come in the form of daily tablets, Evorel Sequi is a patch which is placed on the skin (most women choose to place the patch on their thighs or bottom). Each patch contains enough medicine for three to four days, so must be changed twice per week.

Evorel Sequi patches contains two active ingredients, which emulate the two female sex hormones, oestrogen and progesterone.

Evorel Sequi is a sequential hormone replacement therapy (also referred to as cyclical HRT), because it contains two different types of patches. One patch releases only estradiol — which is a form of oestrogen. The other type releases both estradiol and norethisterone, which is a synthetic version of progesterone.

By using one type of patch for two weeks, then switching to the other, the changes in hormones over the menstrual cycle are closely mimicked, which eases the symptoms of the menopause.

To find out more about how to use this HRT, you can go to our How To Use Evorel Sequi page.

Evorel Sequi Patches
Evorel Sequi Patches
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Summary list of Evorel Sequi side effects

Most women (over 90%) will not experience side effects when using Evorel Sequi, of the few women (less than 10%) who do experience side effects most of these are of relatively short duration as your body becomes accustomed to once again receiving the hormones it has been lacking.

However, as with any medicine, there is always a chance that side effects may occur.

Below is a summary list of the known Evorel Sequi patches side effects:

  • Itchy or inflamed skin where the patch is applied
  • Nausea
  • Headache
  • Mood swings
  • Anxiety
  • Difficulty sleeping and insomnia
  • Stomach pain
  • Muscle pain
  • Joint pain
  • Breast tenderness or pain
  • Fluid retention
  • Breakthrough bleeding or spotting (bleeding when not on your period)
  • Painful periods
  • Vaginal infections (thrush)
  • Premenstrual syndrome (PMS)
  • Digestive issues (such as diarrhoea, gas, bloating, indigestion)
  • Swelling of the legs
  • Anxiety, depression or other changes in mood
  • Dizziness
  • Acne
  • Heart palpitations
  • Migraines
  • Vertigo
  • Hypersensitivity
  • Disturbance to liver function and jaundice
  • Increased blood pressure
  • Blood clots in the blood vessels
  • Gallbladder disease or gallstones
  • Pancreatitis (inflammation of the pancreas)
  • Worsening of fits (epilepsy)
  • Painful/lumpy breasts (fibrocystic breast disease)
  • Increase in the size of uterine fibroids/cysts
  • Chloasma (irregular brown patches on the skin)
  • Alopecia (hair loss)

These side effects range from mild to more serious symptoms.

If you are concerned about any of these effects (particularly if they feel severe, long-lasting or painful), then you should consult your doctor for further guidance.

To find out more about the personal experiences of women who have used Evorel Sequi, you can go to our Evorel Sequi customer reviews page.

More common side effects and symptoms

There are some common Evorel Sequi patches side effects that are more likely to occur, particularly in the first few weeks of using this HRT.

The most common Evorel Sequi side effects that you may experience (affecting between 1 in 10 to 1 in 100 women) include:

  • Itchy, irritated or inflamed skin where the patch is applied
  • Mood swings (feeling depressed, anxious or nervous)
  • Difficulty sleeping
  • Nausea
  • Headache
  • Stomach pain
  • Diarrhoea
  • Muscle pain
  • Breast tenderness and pain
  • Joint pain
  • Weight gain
  • Breakthrough bleeding
  • Painful periods
  • Water retention
  • Bloating

These more common side effects usually do not need medical attention unless severe.

If any of the above Evorel Sequi side effects continue after the first three months of using the HRT, you should consult your doctor so that this can be looked into. They may suggest an alternative medication.

Serious side effects and symptoms

More serious side effects of using Evorel Sequi patches tend to be very uncommon, affecting between 1 in 100 and 1 in 10,000 women.

You should always speak to your GP or dial 111 immediately if you experience serious side effects from any medication, including Evorel Sequi. If you feel like your symptoms are dangerous or life-threatening, you should call emergency services.

These are some of the serious side effects Evorel Sequi:

  • Migraines
  • Vertigo
  • Hypersensitivity
  • Disturbance to liver function and jaundice (symptoms include yellowing of your skin or the whites of your eyes)
  • Increased blood pressure (symptoms can include headaches, tiredness, and dizziness)
  • Blood clots in the blood vessels which may lead to DVT, pulmonary embolism, stroke, or heart attacks (signs are painful swelling and redness of the legs)
  • Gallbladder disease or gallstones
  • Pancreatitis (inflammation of the pancreas)
  • Worsening of fits (epilepsy)
  • Painful/lumpy breasts (fibrocystic breast disease)
  • Increase in the size of uterine fibroids/cysts
  • Chloasma (irregular brown patches on the skin)
  • Alopecia (hair loss)

The above serious side effects are very unusual but it’s worth knowing being aware of just in case you encounter any. If they do occur, you may need medical attention. If in doubt, check with a medical professional immediately.

Does Evorel Sequi cause weight gain?

Weight gain is listed as one of the more common Evorel Sequi side effects (affecting between 1 in 10 and 1 in 100 people who use the HRT patches).

However, it is worth noting that there is no clinical evidence currently available to suggest that weight gain (or loss) is due to HRT treatments such as Evorel Sequi or simply a natural part of the menopause and getting older.

As we get older, we generally become less active, and our bodies change too — we lose lean muscle mass and our metabolism slows as a result. These factors result in weight gain.

The menopause can also cause weight gain; the body’s oestrogen levels naturally decrease in this time, and these hormonal changes are thought to lead to increased appetite, a lower metabolic rate and fat gain.

There is some current research that suggests that HRT such as Evorel Sequi patches might help to slow menopausal weight gain because the oestrogen supplements work to increase the metabolic rate.

If you’re worried that Evorel Sequi weight gain (or Evorel Sequi weight loss, for that matter) is affecting you negatively, then it’s a good idea to speak to your doctor about your concerns. They might recommend a different HRT that may have less of an impact on your weight.

It is also a good idea to read our Evorel Sequi reviews to see what others have experienced.

Evorel Sequi and bleeding: do you have periods on Evorel Sequi patches?

Sequential HRT like Evorel Sequi patches — in which you alternate between two types of patches which release different hormones — mimic the natural hormonal changes of the menstrual cycle.

This means that you will experience a ‘withdrawal bleed’ each month which will be like having a period.

Evorel Sequi bleeding like this is caused by the oestrogen hormone supplement in the first patch making the lining of the womb build up and get thicker and the second patch (containing the progesterone supplement) causing this womb lining to be shed.

During the first three months on Evorel Sequi, you may experience some spotting and breakthrough bleeding as your body gets used to the hormones in the patches.

If any bleeding continues after this initial time period or you’re concerned at any point about heavy bleeding or any other problems, then you should speak to your doctor.

Can Evorel Sequi cause depression?

Depression is listed as one of the more common side effects of Evorel Sequi — meaning it may affect between 1 in 10 and 1 in 100 women who use this HRT.

This is down to the progestogen supplement, norethisterone acetate, in Evorel Sequi patches.

Symptoms of depression include:

  • Sadness
  • Fatigue and low energy
  • Problems with thinking, concentration, or memory
  • Struggling to make decisions
  • Feelings of guilt
  • Low self-esteem and feelings of worthlessness
  • Feelings of hopelessness
  • Feeling worried or anxious
  • Struggling with sleep
  • Restlessness
  • Problems with weight or appetite
  • Irritability
  • Inability to enjoy things that used to be pleasurable
  • Thoughts of death, suicide and harming yourself

Psychological side effects like mood swings and feelings of depression should pass within a few weeks. If you notice feelings of depression persist after this, you should speak to your GP. They may recommend switching to a different type of HRT, trying a different form of progestogen, or lowering your dose.

Allergic reactions to Evorel Sequi

Allergic reactions to Evorel Sequi are very unusual because the hormone substitutes used in the patches are so similar to the hormones the body naturally produces.

However, it is still possible to have an allergic reaction to the patches; it might be that you are allergic to the particular hormone supplements used or other ingredients in the patches, or have a history of severe allergic reactions.

The active ingredients contained in Evorel Sequi are:

  • Estradiol hemihydrate
  • Norethisterone acetate

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

  • Duro-Tak 387-2287
  • Guar gum
  • Hostaphan MN19

The signs and symptoms of a serious allergic reaction include:

  • Skin irritations such as rashes, hives, itching, redness, hot skin, sores
  • Nausea, dizziness and flu-like symptoms
  • Fainting
  • Swelling of the face, throat and tongue
  • Puffiness around the eyes or eyelids
  • Difficult breathing (including very fast or irregular breathing, wheezing, and gasping for breath)
  • Changes in the colour of the skin on the face
  • A fast or irregular heartbeat (palpitations)

If you notice any of the above symptoms and you think you are having an allergic reaction, you should seek emergency medical attention immediately.

Your doctor will be able to advise you on how to proceed with hormone replacement therapy in the future; they may suggest an alternative medication that contains different versions of the hormone supplements.

Mixing Evorel Sequi with other medicines

Mixing Evorel Sequi with certain other medicines can stop the HRT from working as well as it could. One of the results of this is that you may get some bleeding (like a period) when you aren’t expecting it.

This includes medicines that you buy over the counter without a prescription and herbal medicines.

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

  • Epilepsy medicines (e.g. lamotrigine, 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

In regards to the epilepsy medication ‘lamotrigine’, using Evorel Sequi could affect control of your epilepsy.


Although Evorel Sequi has some known (and more common) side effects, these are mild for the majority of women and will usually subside after the first few weeks to months of using the patches while your body adjusts to the new hormone levels in your body.

As with any medication, if you are concerned about any Evorel Sequi patches side effects (including Evorel Sequi) mentioned above, speak to your doctor or pharmacist for advice on how to proceed. They may suggest alternative HRTs or to stop your use of Evorel Sequi.

You can buy Evorel Sequi from The Independent Pharmacy if it is currently prescribed by your doctor and your symptoms are settled. Simply complete our free online consultation form and one of our qualified prescribers can issue your HRT medication the very next day.


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