From the Guidelines
Estradiol transdermal patches that need changing only once weekly include Climara and Vivelle-Dot, which release estrogen continuously through the skin, as recommended by recent studies 1. These patches are typically applied to clean, dry skin on the lower abdomen or buttocks and replaced every 7 days. Common dosages range from 0.025 mg to 0.1 mg per day, with your doctor determining the appropriate strength based on your symptoms and medical history. When starting, begin with the lowest effective dose and follow your doctor's instructions for placement and timing. Weekly patches offer convenience over daily options and provide steady hormone levels, which may result in fewer side effects than oral estrogen. The transdermal route bypasses the liver, potentially reducing risks associated with oral estrogen therapy. Side effects may include skin irritation at the application site, breast tenderness, headaches, or nausea. Always rotate application sites to minimize skin reactions, and consult your healthcare provider before starting any hormone therapy, as estrogen is not appropriate for everyone, particularly those with certain cancers, blood clotting disorders, or liver disease. Some studies have suggested that hormone replacement therapy may be considered in women who experience severe menopausal symptoms, but should generally be used only for a limited period of time and at the lowest effective doses 1. However, the most recent and highest quality study 1 provides the most relevant guidance on the use of estradiol transdermal patches. Key points to consider when using these patches include:
- Starting with the lowest effective dose
- Following your doctor's instructions for placement and timing
- Rotating application sites to minimize skin reactions
- Consulting your healthcare provider before starting any hormone therapy. It is essential to weigh the benefits and risks of hormone replacement therapy, considering individual risks, family history, personal feelings, and relevance of menopausal symptoms 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Estrogen Patch Overview
- The estrogen patch is a form of hormone replacement therapy (HRT) that delivers estradiol through the skin, providing relief from menopausal symptoms such as hot flashes and night sweats 2, 3.
- Studies have shown that the 7-day estrogen patch is effective in reducing the frequency of hot flashes and is well-tolerated, with minimal skin irritation and excellent adhesion 2, 3, 4.
Comparison of Different Estrogen Patches
- A comparative study of a 7-day matrix patch and a twice-a-week reservoir transdermal patch found that the matrix patch was bioequivalent to the reservoir patch, delivering consistent therapeutic levels of estradiol over a 7-day period 5.
- Another study compared the clinical efficacy and plasma estrogen levels of two transdermal delivery systems, a twice-a-week and a once-a-week patch, and found that both treatments had similar clinical efficacy and were well-tolerated 4.
Benefits of Estrogen Patch
- The estrogen patch has been shown to reduce the risk of cardiovascular disease and all-cause mortality when initiated in women under 60 years old and/or at or near menopause 6.
- The patch is a convenient and easy-to-use form of HRT, with a simple application process and minimal maintenance required.
Key Findings
- The 7-day estrogen patch is a effective and well-tolerated form of HRT, with minimal skin irritation and excellent adhesion 2, 3, 4.
- The patch delivers consistent therapeutic levels of estradiol over a 7-day period, making it a convenient and easy-to-use form of HRT 5.
- The estrogen patch has been shown to reduce the risk of cardiovascular disease and all-cause mortality, making it a valuable treatment option for menopausal women 6.