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As a result this medicine should not be used as a first line option for preventing postmenopausal osteoporosis in women over 50. However, it may be used as a second line option for women at high risk of fractures who cannot take other medicines that are licensed for preventing osteoporosis.

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Women considered to be at risk of developing fractures following the menopause include those who have had an early menopause, those with a family history of osteoporosis, those who have had recent prolonged corticosteroid therapy (eg prednisolone), those with a small thin frame, and smokers.

You can read more about the risks and benefits of HRT and other medicines for preventing osteoporosis in the factsheets about menopause and osteoporosis linked above.

How do Evorel conti patches work?Evorel conti patches are a hormone replacement therapy (HRT) preparation. Each patch contains two active ingredients, estradiol (previously spelt oestradiol in the UK) and norethisterone. These are forms of the main female sex hormones, oestrogen and progesterone. Estradiol is a naturally occuring form of oestrogen and norethisterone is a synthetic form of progesterone.

Women’s ovaries gradually produce less and less oestrogen in the period up to the menopause, and oestrogen blood levels decline as a result. The declining levels of oestrogen can cause distressing symptoms, such as irregular periods, hot flushes, night sweats, mood swings and vaginal dryness or itching.

Oestrogen (in this case in the form of estradiol) can be given as a supplement to replace the falling levels in the body and help reduce these distressing symptoms of the menopause. This is known as hormone replacement therapy (HRT). HRT is usually only required for short term relief from menopausal symptoms and its use should be reviewed at least once a year with your doctor.

A progestogen (in this case in the form of norethisterone) is needed as part of HRT for women who have not had a hysterectomy. This is because in women with an intact womb, oestrogen stimulates the growth of the womb lining (endometrium), which can lead to endometrial cancer if the growth is unopposed. A progestogen is given to oppose oestrogen’s effect on the womb lining and reduce the risk of cancer, though it does not eliminate this risk entirely. This is known as combined HRT.

Evorel conti patches are a continuous form of combined HRT. One patch is worn at all times without a break. Each Evorel conti patch contains both estradiol and norethisterone, so that both hormones are received each day. The patches release the hormones through the skin into the bloodstream at a constant rate and are designed to be changed twice a week, ie a patch is worn for three to four days and then replaced with a new one. This type of HRT does not produce a monthly bleed. It is suitable for women whose natural periods have already stopped, eg for postmenopausal women who have not had a period for at least 18 months.

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The declining level of oestrogen at menopause can also affect the bones, causing them to become thinner and more prone to breaking; a condition known as osteoporosis. Oestrogen can therefore also be supplemented to help prevent bone loss and fractures that may occur in women in the years after menopause.

How do I use Evorel conti patches?Follow the instructions provided with your patches carefully. There is general information about how to use your skin patches here. For instance, you could change your patch every Monday and Thursday. Each fresh patch should be applied to a slightly different area to avoid irritating the skin. If a patch falls off before you are due to change it, for example because you have been doing vigorous exercise, sweating excessively,
brooks brothers polo shirts Evorel conti patches estradiol
or wearing clothes that rub the patch, you should replace it with a new one. If a patch falls off in the bath, wait for your skin to cool down before applying a new one. However, you may experience spotting or breakthrough bleeding during the first few months of treatment. Spotting or breakthrough bleeding is more likely if you forget to change a patch on schedule. This risk needs to be weighed against the personal benefits to you of taking HRT. There is more detailed information about the risks and benefits associated with HRT in the factsheet about the menopause linked above. You should discuss these with your doctor before starting HRT. Women on HRT should have regular breast examinations and mammograms and should examine their own breasts regularly. The risk is higher if you have existing risk factors (eg personal or family history of blood clots, smoking, obesity, certain blood disorders see cautions below) and needs to be weighed against the personal benefits to you of taking HRT. There is more detailed information about the risks and benefits associated with HRT in the factsheet about the menopause linked above. For this reason, your doctor may recommend that you stop using HRT for a period of time (usually four to six weeks) prior to any planned surgery, particularly abdominal surgery or orthopaedic surgery on the lower limbs, or if you are to be immobile for long periods. The risk of blood clots during long journeys may be reduced by appropriate exercise during the journey and possibly by wearing elastic hosiery. HRT does not provide contraception for women who fall within this group. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeedingCertain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should not be used by women who are pregnant or breastfeeding. HRT does not provide contraception for women who fall within this group. If you could get pregnant while using this HRT, you should use a non hormonal method of contraception (eg condoms or contraceptive foam). The following are some of the side effects that are known to be associated with this medicine. See also the important information section above. Just because a side effect is stated here, it does not mean that all women using this medicine will experience that or any side effect. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

If you think you have experienced a side effect from a medicine or vaccine you should check the patient information leaflet. This lists the known side effects and what to do if you get them. You can also get advice from your doctor, nurse or pharmacist. If they think is necessary they’ll report it for you.

How can Evorel conti patches affect other medicines?It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while using this one, to make sure that the combination is safe.

The following medicines may potentially reduce the blood level and effect of this medicine, which could cause irregular menstrual bleeding or your symptoms to come back:This medicine may oppose the effect of medicines used to lower high blood pressure. Your blood pressure will usually be checked periodically while you are using HRT, but this is particularly important if you are also taking medicines for high blood pressure.

This medicine may also oppose the fluid losing effect of diuretic medicines.

This medicine may decrease the amount of the antiepileptic medicine lamotrigine in the blood. As this could increase the risk of seizures coming back or getting worse, the medicine may not be recommended for women who take lamotrigine on its own for epilepsy.

This medicine may increase the blood levels of the following medicines and this could possibly increase the risk of their side effects:
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