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Trisequens tablets

Trisequens (84 tablets)

Order before 3pm for delivery from Fri. 18 Jun and Mon. 21 Jun.

Description for Trisequens

Trisequens is a sequential Hormone Replacement Therapy (HRT) suitable for postmenopausal women to offer relief from symptoms of the menopause and prevents osteoporosis. Trisequens contains both synthetic estrogen and progesterone it reduces the risk of developing some cancers for women with an intact uterus compared to some other HRT options. 

Trisequens can be purchased as a repeat prescription online at The Independent Pharmacy for women who have been prescribed it by the GP or specialist and continue to keep their regular check-ups up to date. 

Trisequens Information

  • Age: 18 years +

    Maximum per order: 1

  • Pregnancy: Not suitable

    Breastfeeding: Not suitable

What is Trisequens HRT?

Trisequens is a combined HRT that contains an estrogen called estradiol and synthetic form of the hormone progesterone, norethisterone acetate. It is taken every day without a break to reduce symptoms of the menopause in women who still have a uterus but have not had a period in at least the last 6 months. Trisequens should cause you to have a monthly bleed. 

Trisequens is a sequential type of HRT, which means that inside each pack of 28 tablets, the different colour tablets have different amounts of hormones. This guarantees that you get the most appropriate dose of each hormone throughout the month. 


What is Trisequens used for?

During the menopause, the estrogen levels in a woman's body drop, which can cause women to experience some unwanted symptoms such as night sweats, hot flushes, vaginal dryness and reduced sex drive. Taking estrogen can help to alleviate these symptoms and can also reduce the chance of postmenopausal women developing osteoporosis.


How does Trisequens work?

Trisequens tablets contain both an estrogen and a form of progesterone in varying amounts, which mimic the female body's natural menstrual cycle. Taking additional estrogen after the menopause helps to reduce symptoms by replacing the hormone levels in the blood that would have previously been produced by the ovaries. 

Taking an HRT, such as Trisequens, that also contains progesterone is prescribed to women that are postmenopause but still have a uterus. This is because it has shown to reduce the risk, to women who take HRT, of developing endometrial cancers. 



*Prescription medicines are supplied subject to a medical consultation at the discretion of a doctor.

Trisequens dosage

Trisequens tablets are for oral use only and come in a wheel calendar packet containing 28 tablets. 

Each packet contains blue, white and red tablets which contain different amounts of hormones. When starting your Trisequens tablets you must start with the blue tablets. Once you finish your 28 days of tablets, start your new packet the next day, do not have a break. 

You will take:

  • Blue Tablet: Days 1 - 12, these contain 2 mg estradiol
  • White Tablet: Days 13 - 22, these contain 2 mg estradiol and 1 mg of norethisterone
  • Red Tablet: Days 22 - 28, these tablets contain 1 mg of estradiol 

To start each pack of Trisequens:

  • Turn the inner disk to the blue tablets on the set the day of the week.
  • Break the plastic tab over the tablet and tip the tablet out. 
  • Move the dial clockwise 1 space every day as directed by the arrows and take that tablet. 

Please make sure to read the Patient Information Leaflet thoroughly before starting Trisequens. 

Trisequens side effects

Like all HRT, Trisequens can cause some women to experience unwanted side effects. Most women will find that these improve within the first 3 months. If you find that they do not improve or you are worried you should speak to a doctor for advice. 

If you experience an allergic reaction, severe side effects or any of the health conditions indicated in the warning and precautions section of the Patient Information Leaflet you must seek immediate medical advice either by calling 999 or by attending your nearest emergency department. 

The most common side effects associated with Trisequens are:

  • Headache and migraines
  • Breast tenderness or enlargement
  • Vaginal thrush & vaginal bleeding
  • Nausea & vomiting, abdominal pain
  • Swelling of the hands, ankles and feet & muscle cramps
  • Weight gain
  • Muscle cramps
  • Depression

Trisequens Ingredients

The blue tablets contain the active ingredients: estradiol 2 mg

The white tablets contain the active ingredients: estradiol 2 mg and norethisterone acetate 1 mg

The red tablets contain the active ingredients: estradiol 1 mg

The inactive ingredients in each tablet: lactose monohydrate, maize starch, hydroxypropyl cellulose, talc, magnesium stearate, hypromellose.

The coloured film-coating of the tablets contain: titanium dioxide (E171), indigo carmine (E132), macrogol 400, triacetin, red iron oxide (E172) and propylene glycol

Trisequens warnings

Please make sure to read the Patient Information Leaflet for full details on the warnings and precautions, before starting Trisequens. 

Using any HRT treatment, including Trisequens, carries risks. You should consider these risks and decide whether taking HRT is right for you. If you have any questions or concerns you should discuss these with your GP or specialist. 

Continuing to receive HRT on repeat prescription from The Independent Pharmacy is dependent on you seeing your GP for a check-up at least once a year. 

If you experience any of the following, before or while taking Trisequens, stop taking and consult your doctor immediately:

  • You suspect or develop breast or endometrial cancer
  • You have any unexplained vaginal bleeding or endometrial hyperplasia
  • You have or have ever had a venous blood clot or have a clotting disorder
  • You have had a heart attack, stroke or angina

If you have ever experienced any of the following, consult your doctor before starting Trisequens and again if your condition worsens during treatment:

  • You have recently stopped taking or are currently taking any other prescribed or non-prescribed (including herbal) medication.
  • Uterine fibroids
  • Endometriosis or endometrial hyperplasia
  • High blood pressure or very high levels of fat in your blood
  • Liver, kidney or heart disorders
  • Diabetes, SLE, epilepsy or asthma
  • Gallstones
  • Migraine or severe headaches
  • Hypothyroidism 
  • Hereditary angioedema


Trisequens and cancer

Studies have indicated that taking a combined estrogen-progestogen HRT such as Trisequens can slightly increase your risk of developing breast cancer and ovarian cancer. 

The risk of developing breast cancer increases the longer you take HRT but returns to normal up to 5 years after stopping treatment. For this reason, it is advised that you only take HRT for the shortest amount of time to manage your symptoms. 

You should continue to check your breasts regularly for changes including lumps and dimples if you notice any irregularities you must see a doctor as soon as possible. 


Trisequens and your circulation

Taking any form of HRT makes you 3 times more likely to experience blood clots and 1.5 times more likely to experience a stroke. If you think you are developing symptoms of a blood clot at any time call NHS 111 or are having a stroke call 999.


Trisequens in pregnancy & breastfeeding

Trisequen should only be prescribed for postmenopausal women and is not a contraceptive. If you have had a period in the last 12 months or are under 50 years old you should discuss contraception with your doctor before taking Trisequens. 

If you become pregnant while taking HRT to stop taking it straight away and contact your doctor. You should also not take Trisequens if you are breastfeeding. 

Delivery & Shipping Information

Please note that due to the current situation with COVID-19, Royal Mail are experiencing some delays. This may mean that your order takes longer to arrive than you would normally expect. We are working hard to ensure that, where possible, all orders placed before 15:00 are still dispatched the same working day.


UK Orders

We offer FREE standard tracked delivery on orders over £40.

The following delivery options are available:

  • Standard Tracked Delivery - 2 - 3 day delivery - £2.95
  • Express Tracked Delivery - 1 - 2 day delivery - £4.45
  • DPD Next Day - 1 - 2 working days - £6.95
  • Special Delivery (Guaranteed before 21:00) - £8.95
  • Saturday Guaranteed before 21:00 - £10.45

Important Delivery Information

All our orders are sent out using Royal Mail (unless stated). We always aim to dispatch all Royal Mail & DPD orders received before 15:00 the same working day. Any orders received after 15:00 or over the weekend will be dispatched the next working day. Orders will not be dispatched on weekends or bank holidays.

All orders are subject to approval by our team of doctors and pharmacists. Your delivery date in the checkout is subject to your consultation being approved by our healthcare team.

All orders can be fully tracked from your dispatch email, in your online account and from any notifications from your courier.

We ensure all parcels are in plain packaging for discreet delivery of your medicines and pharmacy goods. Where possible, we will attempt to size all parcels to fit through your letterbox in tamper-proof packaging. By placing an order on our website, you confirm that it is safe and appropriate for a package containing medicines to be posted through your letterbox, if the carrier is able to do so. You should notify our customer support team if it is not safe for the package to be posted through the letterbox, for example due to animals or small children.

Deliveries containing pharmacy-only or prescription medicines may require a signature on receipt. 

Delivery is free for all NHS prescriptions.


Royal Mail


  • Fully tracked delivery
  • SMS & email notifications
  • Four-hour delivery window
  • Change delivery date directly with Royal Mail
  • Update delivery location - add a Safeplace, preferred neighbour, or update your delivery location to a local Post Office or Royal Mail Customer Service Point.

Royal Mail are the most widely recognised mail delivery company in the UK. Being on the UK’s 29 million doorsteps six days a week means they offer unparalleled price and convenience. The Independent Pharmacy uses Royal Mail’s Tracked 48, Tracked 24, and Special Delivery Guaranteed parcel services to offer reliable, fully-tracked delivery at very competitive prices. Your Royal Mail parcel will arrive with your normal daily delivery of post.

Please note: Royal Mail do not deliver on Sundays or Bank Holidays - this should be taken into account when ordering. 

If you are not home to accept your delivery, a card should be left by the Royal Mail representative. This card will provide details of where you can collect the order or how to arrange re-delivery.

Should you be unable to collect your missed delivery or arrange for your medication to be redelivered by Royal Mail, the pharmacy can resend your medication to the same, or a different address provided it has been returned to us and this happens within a 30 day window.

Once a package has been shipped with Royal Mail we advise that you are bound to the terms and conditions of their use together with the terms and conditions contained herein.

You have the right to cancel your order up to the point when your treatment is dispatched. The pharmacist must destroy any medication within 30 days of it being returned, even un-opened boxes, so we are not able to offer refunds once your treatment has been dispatched.




  • Fully tracked delivery
  • SMS & email notifications
  • One-hour delivery window
  • Change delivery date directly with DPD
  • Update delivery location - add a Safeplace, preferred neighbour, or update your delivery location to a local collection point.

DPD Local is the most innovative parcel carrier around. Thanks to their industry-leading Predict service, they provide parcel recipients with a one hour delivery window, notified by email, so you don't have to wait in all day. What's more, it enables receivers to watch the progress of their delivery on a real-time map, all the way down to a final 15 minute time-slot. 

As well as keeping customers informed at every stage of the journey, DPD believe in maximising choice and convenience. That's why DPD provide access to a suite of options both on the day of delivery and the night before, allowing customers to take delivery of their goods in a way that suits. If you wish to reschedule, you can:

  • Select an alternative delivery date
  • Opt for delivery to a nominated neighbour
  • Have the parcel left in a specified safe place
  • Collect the parcel from your local DPD Pickup Shop
  • Upgrade delivery to By 12

Please note: DPD do not deliver on Saturdays, Sundays or Bank Holidays - this should be taken into account when ordering. 

Once a package has been shipped with DPD we advise that you are bound to the terms and conditions of their use together with the terms and conditions contained herein.

You have the right to cancel your order up to the point when your treatment is dispatched. The pharmacist must destroy any medication within 30 days of it being returned, even un-opened boxes, so we are not able to offer refunds once your treatment has been dispatched.


Forwarding houses

We are unable to ship orders to mailing or forwarding houses for onwards shipping to locations outside of the UK.


BFPO Postcodes

Unfortunately we are unable to deliver medicines to BFPO postcodes.


Remote Areas

Please be aware that Royal Mail Guaranteed services are not available to all customers in the UK, especially those that live in remote postcodes. Royal Mail advise customers of the following:

We deliver by 17:30 the next working day in the following postcode areas:
AB30 - 39, 41 - 45, 51 - 56
GY9 Alderney (Channel Islands)
HS1, 3 - 9
IV21 - 28, 40 - 49, 51 - 56
KA27, 28
KW1 - 3, 5 - 15
KW16 Stromness Town only
PA20 (0&9)
PA28 - 38, 41 - 49, 76, 77
PH15, 17 - 26, 31 - 40, 49, 50


We deliver within two working days by 17:30 to the following postcodes areas:
GY1 Herm (Channel Islands)
GY9 Sark (Channel Islands)
PA60 - 75, 78
ZE2, 3


We deliver within three working days by 17:30 to the following postcode areas:
KW16 - non-Town
PH30, 41 - 44


Please note: This applies to our 'Special Delivery' and 'Saturday Guaranteed' services.


International Orders

We are currently unable to ship orders outside of the UK.

We are unable to ship orders to mailing or forwarding houses for onwards shipping to locations outside of the UK.

Need to know more about Menopause (HRT)?

Visit our advice area or contact our support team

Trisequens Reviews

Unsure about a treatment?
Ask our medical team for impartial information and advice about any treatment we provide or medical condition that we treat before you buy.

Authored By:

A photo of  Scott McDougall

Scott McDougall


Published on: 07-12-2020

Last modified on: 07-12-2020

Scott is one of the two founders of The Independent Pharmacy. He is a registered pharmacist and the registered manager of our service with the CQC.

Reviewed By:

A photo of  Andy Boysan

Andy Boysan


Reviewed on: 07-12-2020

Next review date: 07-12-2022

Andy is a co-founder, the superintendent pharmacist and director at The Independent Pharmacy.

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