Tracking combined patch — sequential
A two-phase patch regimen: estrogen-only for the first part of each cycle, then combined patches for the rest. Sequential regimens usually produce a monthly withdrawal bleed — expected, and worth logging as such.
- Schedule
- Patch changes twice weekly (Evorel Sequi) or weekly (FemSeven Sequi), with a mid-cycle switch from estrogen-only patches to combined patches.
- UK names
- Evorel Sequi, FemSeven Sequi
- Route
- transdermal
- In Perity
- A weekly change schedule plus the phase switch — Perity models the progestogen phase explicitly, so your record knows which half of the cycle each day belongs to.
What to log
- The phase switch is the anchor: symptoms that cluster in the combined phase versus the estrogen-only phase are exactly what a dated record can show and memory can't.
- Log the withdrawal bleed like a period so Perity reads it as expected rhythm, not anomaly.
- Keep patch-change days honest — two interleaved schedules (changes and phases) is precisely where a paper diary falls apart.
Questions
Which phase am I in right now?
Your record should answer that at a glance — Perity tracks the phase alongside the patch-change days, so 'the headaches were all in the combined phase' is something you can check rather than remember.
Is a monthly bleed on this regimen normal?
A withdrawal bleed is the expected pattern on sequential regimens. Changes in that pattern are what your clinician wants to know about — which takes a dated bleed log, not an impression.
Symptom guides for combined HRT
- Brain fog
- Anxiety
- Irritability / rage
- Low mood
- Mood swings
- Forgetfulness
- Hot flash
- Night sweats
- Chills / cold flashes
- Palpitations
- Dizziness
- Trouble falling asleep
- All symptoms →
Schedule sources
- Evorel Sequi SmPC (emc 10930)
- Cadences per Perity's sourced schedule reference (emc SmPCs, BMS, NHS, FSRH, FDA — verified 2026-07-01). Cadence facts only, never doses.
Perity informs, never prescribes — decisions belong with you and your clinician.
Educational content, written and maintained by Perity (founder: EiEi), grounded in the sources cited on this page. It is not medical advice, and Perity never interprets your data or recommends treatment. Last reviewed 2026-07-09.
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