Brand Names for Estrogen Patches
The most commonly available estrogen (estradiol) transdermal patches include Climara (once-weekly application), Estraderm/Estraderm MX (twice-weekly application), Vivelle-Dot, Alora, and Minivelle, with Climara being extensively studied for its 7-day wear period and superior adhesion properties. 1, 2
Primary Estrogen Patch Brands
Once-Weekly Patches
- Climara is a 7-day estradiol transdermal system available in 0.05 mg/day and 0.1 mg/day doses, utilizing drug-in-adhesive matrix technology 1, 2
- Climara delivers sustained estradiol blood levels for the full 7 days of patch wear, maintaining a physiologic estrone to estradiol ratio without drug accumulation 1
- Clinical studies demonstrate that Climara has excellent adhesion properties, significantly better than Estraderm, while maintaining similar skin irritation profiles 1, 2
Twice-Weekly Patches
- Estraderm and Estraderm MX are matrix patches delivering 0.05 mg estradiol per day, applied twice weekly for 12-week treatment cycles 3
- Estraderm MX 50 has been shown to significantly reduce moderate to severe hot flushes compared to placebo (P < 0.001) with low rates of skin irritation 3
- Menorest is another matrix system with 3-4 days of suggested use, available in 50 mcg/24h dosing 4
Important Clinical Distinctions
Contraceptive vs. Hormone Replacement Patches
- Ortho Evra is specifically a combination hormone contraceptive patch containing norelgestromin (progestin) and ethinyl estradiol, not pure estradiol for hormone replacement 5, 6
- Ortho Evra delivers approximately 150 mcg of norelgestromin and 35 mcg of ethinyl estradiol daily, with 1.6 times higher estrogen exposure than low-dose combined oral contraceptives 5, 6
- The contraceptive patch has an increased risk of venous thromboembolism compared to other hormonal methods and may be less effective in women weighing more than 198 pounds 5, 6
Application Site Considerations
Optimal Placement for Estradiol Patches
- Estradiol patches should be applied to the abdomen, upper torso, upper outer arm, or buttocks 5
- The buttock provides higher and more consistent absorption of estradiol compared to the abdomen, with mean peak plasma concentration 125.1% and mean relative bioavailability 117.2% of abdominal application 7
- Buttock application may provide an advantage for women experiencing breakthrough menopausal symptoms at the end of the week 7