Is a progesterone (hormone) patch available?

Progesterone Patch Availability

Currently, there is no dedicated progesterone-only transdermal patch available for clinical use, although combination estrogen-progestin patches do exist. 1

Available Hormone Patch Options

• Combination hormone patches: Transdermal patches containing both estrogen and progestin are available:

  • Climara Pro - contains estradiol and levonorgestrel in a 7-day patch 2
  • Fem7 Combi - a sequential system with estradiol mono patch followed by estradiol/levonorgestrel combination patch 3

• Estrogen-only patches: Multiple estradiol-only transdermal patches are available:

  • Applied to abdomen, upper torso, upper outer arm, or buttocks
  • Used for 1-2 weeks depending on formulation
  • Buttock application may provide better absorption (125.1% higher peak concentration) compared to abdominal application 4

Progesterone Administration Options

Since progesterone-only patches are not available, alternative progesterone delivery methods must be used when indicated:

• Oral micronized progesterone: 100-200 mg daily, preferred due to its physiological profile 1
• Vaginal progesterone:
  • 100 mg micronized progesterone administered vaginally has been studied for endometrial protection when used with transdermal estradiol 5
  • 400 mg daily for specific indications like short cervix 1
• Injectable progesterone: 17-alpha-hydroxyprogesterone caproate 250 mg IM weekly for specific indications 1

Clinical Implications

• When endometrial protection is needed with transdermal estradiol therapy, a separate progestogen must be added if using estradiol gels or sprays 6
• For patients requiring only progesterone without estrogen, oral or vaginal formulations remain the standard options
• Transdermal estradiol is often preferred over oral formulations due to:
  • Avoidance of first-pass hepatic metabolism
  • More physiological estradiol:estrone ratio
  • Lower cardiovascular risk profile (reduced VTE and stroke risk) 1

Common Pitfalls

• Assuming all hormone therapies are available in all delivery systems
• Not recognizing that combination patches contain synthetic progestins (like levonorgestrel), not natural progesterone
• Overlooking the need for separate progesterone administration when using estradiol-only patches in women with an intact uterus

For patients specifically requiring progesterone therapy, the clinician must select from available oral, vaginal, or injectable formulations, as the transdermal patch option for progesterone-only delivery does not currently exist.