What are the names of weekly estrogen patches used for Hormone Replacement Therapy (HRT)?

Weekly Estrogen Patches for Hormone Replacement Therapy

The primary weekly estrogen patch used for Hormone Replacement Therapy (HRT) is Climara, which contains estradiol and is applied once weekly for continuous hormone delivery. 1

Available Weekly Estrogen Patches

• Climara: A 7-day estradiol matrix patch that delivers consistent hormone levels throughout the week
  • Available in multiple strengths: 25 μg/day, 50 μg/day, and 75 μg/day 2, 3
  • Provides stable estradiol plasma concentrations with minimal fluctuations compared to oral formulations 4

Advantages of Weekly Patches

• Improved Compliance: Once-weekly application improves long-term adherence compared to daily or twice-weekly options 1
• Stable Hormone Levels: Weekly patches maintain consistent estradiol levels without the large fluctuations seen with oral administration 4
• Reduced Cardiovascular Risk: Transdermal estrogen formulations are preferred over oral formulations due to lower rates of venous thromboembolism (VTE) and stroke 5
• Favorable Estradiol/Estrone Ratio: Weekly patches achieve ratios similar to those during reproductive years 2

Clinical Considerations

• Standard Adult Dosing: 50-100 μg/24 hours for most menopausal women 5
• Maximum Dosing: Up to 100-200 μg/24 hours for severe menopausal symptoms 5
• Application Site: Absorption is higher and more consistent when applied to the buttock compared to the abdomen 1
• Progestin Requirement: Women with an intact uterus must receive progestin along with estrogen to reduce endometrial cancer risk 5

Pharmacokinetics

• Estradiol reaches effective concentrations (>30 pg/ml) within 12 hours of application 4
• After removal, estradiol concentrations return to baseline within 8-24 hours 2
• Weekly patches provide more stable hormone levels compared to oral estradiol, which causes large pulses of estradiol and estrone 4

Potential Side Effects

• Generally well-tolerated with occasional mild and transient skin reactions that typically resolve without discontinuation 2, 3
• Systemic side effects are dose-dependent and typically mild to moderate 3

Monitoring and Follow-up

• Clinical review should occur every 3-6 months initially, then annually to assess symptom control, side effects, and compliance 5

Contraindications

• History of breast cancer or estrogen-dependent neoplasia
• Undiagnosed vaginal bleeding
• Active thromboembolic disorders
• Hormonally mediated cancers 5