Combined HRT patch (oestrogen + progestogen)
Estradiol with levonorgestrel
Brand names: FemSeven Conti, FemSeven Sequi
Adult dose
Dose: 1 transdermal patch twice weekly (apply per regimen)
Route: Transdermal
Frequency: Twice weekly
Clinical pearls
- Transdermal route preferred in raised VTE/migraine/obesity per NICE NG23
- Sequential vs continuous preparation depends on time since last menstrual period
Contraindications
- Standard HRT contraindications (see estradiol)
- Skin disease at application site
Side effects
- Application-site reactions
- Breast tenderness
- Bleeding
- VTE (lower transdermal vs oral)
Interactions
- CYP3A4 inducers
Monitoring
- BP
- Bleeding pattern
- Breast awareness
Reference: BNF; NICE NG23; British Menopause Society; https://bnf.nice.org.uk/drugs/estradiol-with-levonorgestrel/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Spinal Anaesthesia Hypotension Management · AAGBI; ASA
- Pre-Eclampsia / Eclampsia in ED · NICE NG133; RCOG Green-top 10A
- Suspected Ectopic Pregnancy · NICE NG126; RCOG Green-top 21
- Polycystic Ovary Syndrome (PCOS) · International PCOS Guideline 2023; NICE CKS
- Pre-eclampsia Management · NICE NG133 2019
- Ectopic Pregnancy · NICE CG154 / RCOG GTG 21