Trisequens is a hormone replacement therapy (HRT), also called hormone therapy (HT), preparation. It is used to treat women with menopausal symptoms. Trisequens tablets contain estradiol (oestrogen) and norethisterone (progestogen). More information

A doctor will review your order and write you a prescription, if appropriate. This prescription is then forwarded to a pharmacy. The pharmacy will have your medicine delivered to you within one to three working days. Read more about this process here.

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Patient Leaflet(s)

What is Trisequens?

Trisequens is a hormone replacement therapy (HRT), also called hormone therapy (HT), preparation. It is used to treat women with menopausal symptoms. Trisequens tablets contain estradiol (oestrogen) and norethisterone (progestogen). These hormones restore hormonal balance in the body, and so reduce menopausal symptoms. Trisequens is a prescription-only medicine.

What is Trisequens used for?

Trisequens helps relieve physical and psychological symptoms caused by menopause. Around the age of 45, women's ovaries start producing less and less oestrogen, and oestrogen levels decline as a result. The declining levels of oestrogen can cause distressing symptoms such as:

  • Hot flashes;
  • Vaginal discomfort;
  • Night sweats;
  • Sleeping difficulties;
  • Mood swings, anxiety or depression.

The oestrogen (in this case in the form of estradiol) in Trisequens replaces falling oestrogen levels in the body and so helps reduce these uncomfortable symptoms. As oestrogen stimulates the growth of the womb lining, Trisequens also contains a progestogen (in this case in the form of norethisterone) to oppose oestrogen's effect on the womb lining. Trisequens is a type of HRT that is more suitable for women with an intact womb who are still having (irregular) periods, because it produces a monthly withdrawal bleed.

How to use Trisequens

Each blister pack of Trisequens consists of three types of tablets (28 in total):

  • The blue tablets taken on the first 12 days of each Trisequens cycle contain only estradiol.
  • The white tablets taken for the next 10 days of each cycle (day 13 to 22) contain both estradiol and norethisterone.
  • The red tablets taken from day 23 to 28 contain just estradiol.

Trisequens tablets are taken back to back without a tablet-free interval. The tablets should be taken at the same time each day with some water. They can be taken with or without food. A withdrawal bleed usually occurs in the last week of each cycle. Trisequens tablets come in convenient calendar packs. Consult the package leaflet for instructions on how to take the tablets.


The usual dose for treating adult women is:

  • one tablet once daily.

Always follow the prescription exactly - never take more or less than the doctor recommends.

Side effects

HRT may cause side effects. The following are some of the side effects that are known to be associated with Trisequens:

  • Breast tenderness or soreness;
  • Headache or migraine;
  • Nausea;
  • Breakthrough bleeding (spotting);
  • Fluid retention;
  • Loss of libido (sex drive);
  • Mood swings.

Consult a doctor if the side effects are persistent or severe. See the package leaflet for a full list of side effects, including rare yet serious side effects.

When not to use Trisequens

Trisequens is not suitable for everyone and should not be used if:

  • You are allergic to estradiol, norethisterone or any other ingredient in this medicine;
  • You have a known or past history of thrombosis or liver disease;
  • You have active breast cancer or a history of breast cancer or other hormone-related cancer;
  • You have a blood disease or kidney disorder, vaginal bleeding of unknown cause or an overgrowth of the lining of the womb (endometrial hyperplasia).

Be sure to tell the doctor if you have a health condition that is not listed above or are currently taking medication. The doctor will be able to advise on possible drug interactions.

Pregnancy/driving ability/alcohol

Do not use this medicine if you are pregnant or breastfeeding. Trisequens does not protect against pregnancy. If you are still capable of becoming pregnant you should use some form of contraception. This medicine does not interact with alcohol or affect your ability to drive safely.