From the Guidelines
To use Estrogel properly, apply one pump (1.25 g) of the gel once daily to clean, dry skin on one arm, from the wrist to the shoulder, as transdermal administration of 17βE is preferred due to its better safety profile and beneficial effects on circulating lipids, markers of inflammation, and blood pressure 1. When using Estrogel, it is essential to follow the recommended application guidelines to ensure optimal absorption and minimize potential side effects.
- Apply the gel at approximately the same time each day to maintain consistent hormone levels.
- Spread the gel thinly and allow it to dry completely before dressing.
- Wash your hands thoroughly after application to avoid transferring the medication to others.
- Do not apply Estrogel to breasts, face, vaginal area, or irritated skin.
- For best absorption, avoid washing the application area for at least one hour after use. The transdermal administration of 17βE, as found in Estrogel, has been shown to mimic physiological serum estradiol concentrations, providing a better safety profile than oral formulations 1.
- This route of administration avoids the hepatic first pass effect and minimizes the impact of estrogens on the synthesis of hemostatic factors.
- It also has a more beneficial profile on circulating lipids, markers of inflammation, and blood pressure, compared to oral estrogen replacement therapy 1. If you miss a dose, apply it when you remember, but if it's almost time for your next dose, skip the missed one and continue your regular schedule. Never apply double doses to make up for missed applications. Most women begin to notice symptom improvement within a few weeks, though full benefits may take 1-3 months, as Estrogel works by supplementing estrogen levels that decline during menopause, helping to reduce hot flashes, night sweats, and vaginal dryness.
From the FDA Drug Label
PACKAGE LABEL.PRINCIPAL DISPLAY PANEL Package Label – 0.0375 mg NDC 70771-1564-8 Estradiol Transdermal System, USP (Twice-Weekly) Delivers 0.0375 mg/day Includes 8 Systems Rx Only zydus pharmaceuticals PACKAGE LABEL.PRINCIPAL DISPLAY PANEL Package Label – 0.1 mg NDC 70771-1567-8 Estradiol Transdermal System, USP (Twice-Weekly) Delivers 0.1 mg/day Includes 8 Systems Rx Only zydus pharmaceuticals PACKAGE LABEL.PRINCIPAL DISPLAY PANEL Package Label – 0.075 mg NDC 70771-1566-8 Estradiol Transdermal System, USP (Twice-Weekly) Delivers 0.075 mg/day Includes 8 Systems Rx Only zydus pharmaceuticals
The Estradiol Transdermal System should be applied twice-weekly. The available strengths are 0.0375 mg/day, 0.075 mg/day, and 0.1 mg/day. Each package includes 8 systems.
From the Research
Estrogel Usage
To use Estrogel, it is essential to understand the context of its application. Estrogel is a form of hormone replacement therapy (HRT) that contains estrogen, which is used to treat menopause-associated vasomotor symptoms (VMS) such as hot flashes and night sweats 3, 4.
Administration and Dosage
The dosage and administration of Estrogel should be determined by a healthcare provider, as it depends on the individual's medical history and the severity of symptoms. Generally, HRT, including Estrogel, should be used at the lowest effective dose and for the shortest duration possible, preferably less than 5 years 3.
Treatment Considerations
When considering the use of Estrogel, it is crucial to weigh the potential benefits against the risks. The decision to use HRT should be made on an individual basis, taking into account the woman's health status, medical history, and personal preferences 4, 5. For women who cannot or choose not to use HRT, non-hormonal therapies and lifestyle changes may be alternative options for managing VMS 3, 5.
Lifestyle Changes and Non-Hormonal Therapies
Lifestyle changes, such as regulating core body temperature, practicing relaxation techniques, engaging in regular physical activity, losing weight, and quitting smoking, may help reduce the risk of VMS and should be implemented by all women with menopause-associated VMS 3. Non-hormonal therapies, including selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, gabapentin, and clonidine, may be appropriate alternatives for women who cannot or will not use HRT 3, 5.
Patient Preferences and Willingness to Pay
Studies have shown that women's treatment preferences for VMS are influenced by factors such as sleep improvement, reduction in VMS frequency and severity, and the risk of breast cancer and cardiovascular events 6. Women are willing to pay more for treatments that offer substantial improvements in sleep and VMS symptoms 6.
Clinical Guidelines
Clinical guidelines recommend that HRT, including Estrogel, be used for the treatment of moderate to severe VMS in healthy, symptomatic women under the age of 60 or within 10 years of their final menstrual period 4, 7. An individualized approach to treatment is recommended for women with medical comorbidities 4.