Types of HRT in the UK: Patches, Tablets and Options Explained
Article written by Dr Emma Ginns and Dr Mari Walling, British Menopause Society Registered Specialist GPs, Co-founders of Lemala Health, March 2026
This information is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider for personal guidance.
There are several different types of HRT available in the UK, including patches, gel, spray and tablets. Understanding the differences between these options can help you make informed decisions about your menopause treatment.
In this guide, we explain the main types of HRT, how they work, and when each option may be used.
Understanding HRT Options in the UK
Currently, many women in the UK who start hormone replacement therapy (HRT) are prescribed oestrogen through the skin, such as patches, gel or spray, alongside oral progesterone or a hormone coil (such as the mirena) if they still have their womb.
This is often recommended as a first option because it is effective for symptom control and avoids first-pass metabolism in the liver, which may reduce the risk of certain side effects.
However, other HRT options are available, and in this guide we explore the alternative ways to use HRT.
Why Are There Different Types of HRT?
HRT is not a single treatment, but a group of therapies designed to replace hormones that fall during perimenopause and menopause.
There are many HRT options available, including transdermal oestrogen, combined patches and oral HRT medications. These may be appropriate depending on your symptoms, stage of menopause, medical history and personal preferences.
Different types of HRT exist because:
• some women still have periods, while others do not
• some women still have a uterus and need endometrial protection, others have had a hysterectomy
• women respond differently to different hormones
• preferences vary (for example, tablets vs patches, oral medication vs transdermal (through the skin)
For many women, finding the right HRT involves adjusting the type or dose over time.
You may also find it helpful to read our guides on how to use oestrogen patches, gel, spray and tablets and how to use Utrogestan and Gepretix (micronised progesterone) as part of HRT.
Combined HRT Patches
Some patches contain both oestrogen and a progestogen, meaning only one treatment is needed.
They are usually changed once or twice a week and are absorbed through the skin.
Common Examples in the UK
Evorel Sequi: a sequential (cyclical) HRT patch.
Sequential HRT is typically used for women who are still having periods (during perimenopause).
Because progesterone is taken for part of the cycle, this regimen is designed to produce a monthly withdrawal bleed.
It includes:
• an oestrogen-only patch
• a combined patch containing oestrogen and norethisterone
Only one strength is available which includes 50mcg of oestradiol.
Evorel Conti: is a continuous combined patch.
It contains estradiol and norethisterone, delivered continuously, at the same dose throughout the month.
This helps keep the lining of the womb stable, and most women do not have regular bleeding once established on treatment.
It is usually prescribed after menopause, when periods have stopped for at least 12 months.
Only one strength is available which includes 50mcg of oestradiol.
Estradot Conti: is another continuous combined patch.
The estradiol dose is slightly lower than in evorel conti, which may suits some women.
It also contains estradiol and a progestogen and works in a similar way to Evorel Conti, but is available in a different size and strength which may suit different preferences.
Combined HRT Tablets
Some women prefer to take HRT as a daily tablet rather than using patches, gel or spray.
Until around 5 years ago, this was the most common way to take HRT within the UK.
These contain both oestrogen and a progestogen. Many are available for both perimenopause, and menopause.
Examples
Femoston / Femoston Conti
Femoston contains estradiol and dydrogesterone.
Dydrogesterone is often well tolerated and may cause fewer side effects for some women.
Elleste Duet / Elleste Duet Conti
Elleste contains estradiol and norethisterone.
Premarin and Prempak-C
These are different to the other types of HRT. They both contain conjugated equine estrogens (CEE), and the combined product includes the progestogen norgestrel.
Body-Identical Combined HRT
Bijuve
Bijuve is a combined oral HRT containing estradiol and micronised progesterone.
Both hormones are body-identical, meaning they are the same as those produced naturally by the body.
It is taken as a single daily capsule.
Oral Progesterone
Micronised progesterone (eg. Utrogestan / Gepetrix ) is a commonly used body-identical progesterone and is often prescribed alongside oestrogen.
This is covered in much more detail in our separate resource available here:how-to-use-utrogestan-and-gepretix-micronised-progesterone-as-part-of-hrt
Oral Oestrogen
Oestrogen-only tablets may be used by women who:
• have had a hysterectomy
• or are taking a separate progesterone
Examples include:
Zumenon and Elleste Solo which contain estradiol and are available in different strengths.
It may be used on its own or alongside a separate progestogen if needed.
Tibolone
Tibolone is different from standard HRT.
It is a synthetic hormone with oestrogen-like, progestogen-like and androgen-like effects in the body.
It is taken as a single daily tablet.
It may help with:
• hot flushes
• sleep disturbance
• vaginal symptoms
• reduced libido in some women
It is usually prescribed after menopause, once periods have stopped
Progestogens Used Alongside HRT
If you still have a uterus, a progesterone or progestogen, or mirena coil (or similar) is needed to protect the lining of the womb when taking oestrogen.
Sometimes this is prescribed as a separate medication.
Examples
Provera ((medroxyprogesterone acetate)
A progestogen used in cyclical or continuous regimens for endometrial protection.
Norethisterone
A synthetic progestogen used in both cyclical and continuous regimes, and included in some combined patches.
Nalvee (dydrogesterone)
Contains dydrogesterone and may be used alongside oestrogen as part of a combined HRT regime.
Slynd
A progestogen-only contraceptive pill.
In some cases, it may be used off-licence as part of HRT
Testosterone in HRT
For information on testosterone use as part of HRT regimes, please see this resource:
Do Different Types of HRT Have Different Benefits or Side Effects?
Different types of HRT can suit different women.
For example:
• Some progestogens are better tolerated than others, and may cause fewer side effects such as low mood, bloating or breast tenderness
• Transdermal oestrogen (patch, gel or spray) is often preferred where there are risk factors for blood clots, as it avoids the liver
• Oral HRT may be convenient for some women, but can be associated with a slightly higher risk of blood clots compared to transdermal options
• Some treatments, such as tibolone, may have additional effects on libido for some women
However, responses to HRT vary widely.
A preparation that suits one woman very well may not suit another.
For this reason, it is often helpful to review and adjust treatment over time.
Choosing the Right Type of HRT
There is no single “best” type of HRT. It is common for treatment to be adjusted over time.
The most suitable option depends on:
• your stage of perimenopause or menopause
• whether you have a uterus
• your medical history
• your preferences
• how your body responds to different hormones
How We Can Help
If you are unsure which type of HRT may be right for you, a personalised discussion can help you explore your options.
At Lemala Health, we provide individualised, evidence-based menopause care, helping you find a treatment approach that fits your symptoms, health and lifestyle.