Mechanism of Action: Delivers estradiol through the skin directly into the bloodstream, mimicking the natural estrogen produced by the ovaries.
Indications
Primary Use: Hormone Replacement Therapy (HRT) for the management of menopausal symptoms, including hot flashes, vaginal dryness, and bone loss prevention.
Other Uses: May also be used for gender-affirming hormone therapy and to prevent osteoporosis in postmenopausal women.
Dosage
Adults: Dosage and application schedule vary by brand and individual needs. Typically, one patch is applied twice weekly or weekly, depending on the formulation.
Elderly: Dosage may be adjusted based on individual efficacy and tolerability.
Children: Not applicable for pediatric use.
Administration
Method: Transdermal patches are applied to clean, dry, and less hairy areas of the lower abdomen or buttocks. Avoid applying the patch to the breasts.
Precautions: Rotate patch sites to reduce irritation, and do not apply the patch to the same site consecutively.
Forms Available
Transdermal Patches: Available in varying dosages, such as 0.025 mg/day, 0.05 mg/day, 0.075 mg/day, 0.1 mg/day.
Side Effects
Common: Skin irritation at the patch site, redness, itching.
Less Common: Breast tenderness, headache, abdominal pain.
Rare but Serious: Blood clots, stroke, gallbladder disease, increase in blood pressure.
Warnings
Black Box Warning: Estrogens may increase the risk of endometrial cancer, stroke, deep vein thrombosis, and dementia in postmenopausal women.
Contraindications: Known, suspected, or history of breast cancer, active deep vein thrombosis, pulmonary embolism, or a history of these conditions.
Precautions
General: Regular monitoring of endometrial and breast health is recommended. Women with a uterus should use estrogen with a progestin to avoid increased risk of endometrial cancer.
Health Conditions: Use with caution in patients with a history of liver disorders, thrombophilic disorders, or estrogen-sensitive cancers.
Interactions
Medications: May interact with thyroid hormone replacement therapy, warfarin, and some herbal supplements like St. John’s Wort.
Food: Generally, there are no significant food interactions, but maintaining a consistent diet helps manage side effects.
Monitoring Parameters
Bone Density: For those using the therapy for osteoporosis prevention.
Blood Pressure: Regular monitoring recommended due to potential increases.
Liver Function: Periodic liver function tests may be warranted.
Use in Pregnancy
FDA Category: X. Contraindicated in pregnancy; should not be used.
Use in Elderly
Considerations: Initiate treatment with the lowest effective dose and monitor closely for adverse effects, particularly cardiovascular.
Use in Kidney Disease
Adjustments: No specific dose adjustment necessary, but monitor for side effects.
Use in Liver Disease
Caution: Estrogens are metabolized by the liver; careful monitoring and possible dose adjustments are needed in liver impairment.
Patient Counselling Points
Medication Use: Proper application technique for patches is crucial for effectiveness.
Side Effects: Instruct patients to report any unusual vaginal bleeding, changes in vision, or signs of blood clots.
Lifestyle: Advise avoiding smoking, which may exacerbate cardiovascular risks.
Table of Brand Names, Manufacturer, and Prices in USD
Brand Name
Manufacturer
Strength/Dosage Form
Price (USD)
Vivelle-Dot
Novartis
0.05 mg/day Patch
$1.90
Climara
Bayer
0.075 mg/day Patch
$1.70
Estraderm
Novartis
0.1 mg/day Patch
$2.00
15 FAQs with Answers
What is the main use of Estradiol patches? – Primarily for treating menopausal symptoms and preventing osteoporosis.
How often should I change my Estradiol patch? – Depending on the brand, either once or twice a week.
Can Estradiol patches cause skin irritation? – Yes, it’s a common side effect.
Are there any serious risks associated with Estradiol patches? – Yes, including blood clots and stroke, particularly in smokers.
How do Estradiol patches work? – They deliver estrogen through the skin, which helps regulate hormone levels.
Can I apply a patch to my arm or leg? – No, it should be applied to the lower abdomen or buttocks.
What should I do if a patch falls off? – Apply a new patch and continue your regular patch change schedule.
Is it safe to use Estradiol patches long-term? – Long-term use has associated risks; discuss with your doctor.
Can men use Estradiol patches? – Yes, in gender-affirming therapy under medical supervision.
How should I store the patches? – Keep them in their original packaging at room temperature.
What happens if I miss changing a patch on time? – Apply a new patch as soon as you remember.
Can I swim or shower with the patch on? – Yes, patches are designed to be water-resistant.
What precautions should I take? – Regular check-ups for breast and endometrial health are recommended.
Who should avoid using Estradiol patches? – Those with a history of hormone-sensitive cancers or clotting disorders.
How do I dispose of used patches? – Fold sticky ends together and dispose of safely out of reach of children and pets.