Where can Estrogel (estradiol) be applied?

Application Sites for Estrogel (Estradiol)

Estrogel should be applied to the skin of the arms, shoulders, or abdomen, avoiding breast tissue and genital areas. 1, 2

Recommended Application Sites

• Estrogel is a transdermal estradiol gel formulation that should be applied to specific body areas for optimal absorption and safety 1
• The primary recommended application sites include:
  • Upper arms 3, 2
  • Shoulders 2
  • Abdomen 3, 2
• The gel should be applied to clean, dry skin and allowed to dry before covering with clothing 4
• Application should cover approximately 200-400 cm² of skin surface area for proper absorption 4

Areas to Avoid

• Breast tissue should be avoided to prevent direct exposure to breast tissue 3
• Genital areas should not be used for application 2
• Broken or irritated skin should be avoided 4
• Do not apply to the face 2

Application Technique

• Apply with clean hands and spread in a thin layer over the recommended areas 4
• Allow the gel to dry completely (approximately 2-5 minutes) before covering with clothing 2
• Wash hands thoroughly after application to avoid transferring estradiol to others 2
• Rotate application sites to prevent skin irritation 4

Important Considerations

• Transdermal application avoids first-pass hepatic metabolism, allowing for lower doses and more stable hormone levels compared to oral administration 5
• Approximately 10% of the applied dose is absorbed through the skin 6
• The typical absorption rate is about 0.06% (w/w) estradiol per application 4
• Local skin irritation is the most common adverse effect of transdermal estradiol application 5

Clinical Advantages of Transdermal Application

• Transdermal delivery provides more stable serum estradiol levels compared to oral administration 5
• Avoids hepatic first-pass metabolism, which reduces the risk of liver-related side effects 5
• May have a more favorable cardiovascular risk profile compared to oral estrogen, particularly important for cancer survivors who already have increased cardiovascular risk 3

Precautions

• Avoid skin-to-skin contact with others, especially children and pregnant women, at the application site until the gel has dried completely 2
• Do not apply other topical products to the same area until estradiol gel has dried 4
• Patients should be aware that swimming or bathing shortly after application may reduce absorption 2

Remember that proper application technique is essential for achieving consistent hormone levels and therapeutic efficacy while minimizing side effects and accidental transfer to others.