In menopause care, cyclical combined hormone replacement therapy (HRT), also called sequential combined HRT, uses oestrogen and a progestogen on a planned schedule. This article explains that specific treatment. The words “combined therapy” alone do not identify a medicine, diagnosis or treatment plan.
What does the schedule mean?
Sequential combined HRT is commonly offered to people who have menopause symptoms and still have periods. Oestrogen is taken continuously, while the progestogen is added for part of each monthly cycle. The exact schedule depends on the prescribed product. Continuous combined HRT uses both hormones every day and is generally considered after menopause. Do not change between these schedules without advice from your prescriber. NHS: types of HRT
Why are two hormones used?
For people who still have a womb, progestogen helps protect its lining when systemic oestrogen is used. The appropriate treatment depends on whether you have had a hysterectomy, your stage of menopause and your medical history. NHS: types of HRT
What should you expect?
HRT can relieve menopause symptoms, but the response is not immediate or identical for everyone. The NHS advises that full symptom improvement can take up to three months. Discuss continuing symptoms or side effects with your clinician; a different preparation or dose may be appropriate. A withdrawal bleed commonly follows the progestogen course. NHS: sequential HRT questions
Is this the same as birth control?
No. Sequential HRT does not prevent pregnancy. If pregnancy is still possible, discuss suitable contraception with a clinician. Treatment decisions also require an individual assessment of benefits and risks, including breast cancer and blood-clot risks; they should not be based on promises of general “hormone balance.” NHS: sequential HRT questions
This is general educational information, not a personal prescription. Bring your symptoms, bleeding history and current medicines to a consultation so the discussion addresses your circumstances.
