Frequently asked questions about Evorel®
Can I use Evorel as a contraceptive?
The levels of hormone from the patches are too low to act as a contraceptive.
Talk to your doctor for advice on contraception.
What happens if I get breakthrough bleeding or spotting?
Breakthrough bleeding or spotting is usually nothing to worry about, especially during the first few months of using HRT.
But if the bleeding or spotting:
- Carries on for more than the first few months
- Starts after you have been on HRT for a while
- Carries on even after you have stopped using HRT,
make an appointment to see your doctor as soon as possible. It could be a sign that your endometrium has become thicker.
What happens if I use more Evorel than I should?
It is unlikely that you will have too much of the hormones in Evorel. The most common symptoms of having too much oestrogen in your body are:
- Tender or painful breasts
- Feeling sick (nausea) or being sick
- Unexpected vaginal bleeding
- Stomach pain or bloating
Removing the patch can reverse the effects of too much oestrogen. Talk to your doctor or pharmacist before using any more patches. Your doctor may decide to change the size of patch.
What side effects may I experience?
Like all medicines, Evorel can cause side effects, although not everybody gets them. Some side effects may be due to any progestogen that is being taken at the same time.
The following diseases are reported more often in women using HRT compared to women not using HRT:
- breast cancer
- abnormal growth or cancer of the lining of the womb (endometrial hyperplasia or cancer)
- ovarian cancer
- blood clots in the veins of the legs or lungs (venous thromboembolism)
- heart disease
- probable memory loss if HRT is started over the age of 65
For further information, please consult the Patient Information Leaflet.
Am I at risk of developing Cancer?
HRT is not recommended for women who have ever had cancer of the lining of the womb.
Using oestrogen-only HRT for a long time can increase the risk of cancer of the lining of the womb (the endometrium). Having a progestogen as well as the oestrogen helps to lower the extra risk.
If you still have your womb, your doctor will usually prescribe a progestogen as well as oestrogen. These may be prescribed separately, or as a combined HRT product.
If you have had your womb removed (a hysterectomy), your doctor will discuss with you whether you can safely have oestrogen without a progestogen.
If you have had your womb removed because of endometriosis, any endometrium left in your body may be at risk of cancer. This means your doctor may prescribe HRT that includes a progestogen as well as an oestrogen.
Your product, Evorel, is an oestrogen-only HRT.
How likely is endometrial cancer?
Looking at women aged 50 to 65 years, who still have a womb, on average,
over the next 15 years:
• In women not taking HRT – 5 in 1000 will get endometrial cancer
• In women taking oestrogen-only HRT, the number will be 2 to 12 times higher (an extra 5 to 55 cases), depending on the dose and how long you take it for.
The addition of a progestogen to oestrogen-only HRT substantially reduces the risk of endometrial cancer.
Women who have breast cancer, or have had breast cancer in the past should not have HRT.
Having HRT slightly increases the risk of breast cancer. The risk is also slightly increased if you have a later menopause.
- Postmenopausal women taking oestrogen-only HRT for 5 years – the risk is about the same as for a woman of the same age who is still having periods over that time, and not taking HRT
- Women taking oestrogen plus progestogen HRT – the risk is higher than for oestrogen-only HRT. However, oestrogen plus progestogen HRT isbeneficial for the endometrium (see ‘Endometrial cancer’)
For all kinds of HRT, the extra risk of breast cancer goes up the longer you take it. However, it returns to normal within about 5 years after stopping HRT. For women who have had their womb removed and who are using oestrogen-only HRT for 5 years, little or no increase in breast cancer risk is shown.
Your risk of breast cancer is also higher if:
- You have a close relative (mother, sister, or grandmother) who has had breast cancer
- You are very overweight
How likely is breast cancer?
Looking at women aged 50 to 79, on average, over the next 5 years:
- In women not taking HRT – between 9 and 17 in 1000 will get breast cancer
- In women taking oestrogen-progestogen HRT at age 50 to 79, and take it for 5 years, between 13 and 23 in 1000 will get breast cancer (an extra 4-6 cases)
If you notice any changes in your breast, such as:
- Dimpling of the skin
- Changes in the nipple
- Any lumps you can see or feel
Make an appointment to see your doctor as soon as possible.
Ovarian cancer (cancer of the ovaries) is rare, much rarer than breast cancer. The use of oestrogen-only or combined oestrogen-progestogen HRT has been associated with a slightly increased risk of ovarian cancer.
The risk of ovarian cancer varies with age. For example, in women aged 50 to 54 who are not taking HRT, about 2 women in 2000 will be diagnosed with ovarian cancer over a 5-year period. For women who have been taking HRT for 5 years, there will be about 3 cases per 2000 users (i.e., about 1 extra case).