Can the estradiol (estrogen) patch be stopped?

Stopping the Estradiol Patch

Yes, the estradiol patch can be safely stopped, but proper discontinuation procedures should be followed to minimize potential side effects and ensure continued contraceptive protection if needed. 1, 2

Discontinuation Considerations

When discontinuing the estradiol patch, consider the following factors:

Contraceptive Use

If the patch is being used for contraception:

• Stopping the patch mid-cycle may lead to unscheduled bleeding and loss of contraceptive protection 1, 2
• If contraception is still needed, another contraceptive method should be started immediately to maintain protection 1
• Emergency contraception may be needed if unprotected intercourse occurred within 5 days of stopping the patch 1

Hormone Withdrawal Effects

• After patch removal, estradiol levels gradually decrease with a half-life of approximately 2.7 hours (161 minutes) 3
• Weight may influence the half-life of estradiol, with heavier individuals potentially experiencing longer half-lives 3
• Withdrawal symptoms may include:
  • Return of menopausal symptoms if used for hormone replacement therapy 4
  • Possible unscheduled bleeding or spotting 1

Specific Discontinuation Protocols

For Contraceptive Patches

• Complete the current cycle before discontinuation when possible 1, 2
• If stopping mid-cycle, use backup contraception (e.g., condoms) or avoid sexual intercourse for 7 days if continued contraception is needed 1
• Consider starting a new contraceptive method immediately if contraception is still required 1

For Hormone Replacement Therapy

• Gradual discontinuation may help minimize rebound symptoms 4
• Monitor for return of menopausal symptoms, which may occur within days of stopping due to the relatively short half-life of estradiol 3

Special Considerations

Adverse Reactions

• If stopping due to skin irritation (which occurs in approximately 15% of users), alternative estrogen delivery methods can be considered 5, 6
• For allergic contact dermatitis from transdermal estradiol (rare), be aware that oral estrogens may also cause systemic reactions in sensitized individuals 5

Storage of Unused Patches

• If discontinuation is temporary, unused patches can be stored for at least 1 month at temperatures ≤35°C without significant degradation (for most patch types) 7
• Estraderm MX, Systen, and Oesclim patches maintain stability when stored at room temperature or slightly elevated temperatures 7

Monitoring After Discontinuation

• Follow up to ensure resolution of any adverse effects that prompted discontinuation 5
• Assess for return of symptoms that were being treated with estradiol 4
• Consider alternative treatments if symptoms return and require management 4, 6