Article Content 5 min read
Menopausal hormone therapy comes in many forms; hormones can be delivered to your body via pill, cream, patch, or the vaginal route. For many women, hormone replacement patches are the preferred method of hormone replacement. The patches are small, sticker-like adhesives that are embedded with hormones to allow for delivery through direct, skin absorption. They are dosed to be changed either weekly or twice weekly. Sounds easy, right? But how do you know if hormone replacement therapy patches are right for you?
Types of Menopausal Hormone Patches
There are two types of menopausal hormone replacement patches available to women. The first is an estradiol patch, which only contains estrogen. These work best for patients who do not need progesterone therapy concurrently - for example, women who have had a hysterectomy, are already taking a progesterone supplement, or have a progesterone IUD (intrauterine device).
The second type of menopausal hormone patch contains both estradiol (estrogen) and progesterone. The addition of the progesterone is important for women who still have their uterus, in order to protect the uterus against overgrowth of its cellular lining in response to estrogen (a condition called endometrial hyperplasia). The estradiol and progesterone combination patch helps to make it easier for women to take both of these medications at once.
Benefits of the Hormone Patch
There are many benefits of taking your menopausal hormone therapy via a patch. Because the patch will stay adherent to your skin, you will experience a steady, more consistent delivery of low-dose estrogen to relieve your menopausal symptoms thoughout the day. Having a consistent dose of estrogen circulating in your body can also significantly improve any vaginal health issues you may be experiencing, including vaginal dryness or decreased vaginal lubrication. Receiving estrogen replacement or treatment via a patch bypasses your gastrointestinal tract for processing of the hormone, which can be safer for some patients when compared to taking hormones orally.
Traditional oral hormones pass through your stomach and then are processed by first-pass through your liver, before being disseminated to the rest of your body. Using a transdermal (through your skin) medication like the estradiol patch, bypasses this first-pass by the liver. After being absorbed through your skin, the hormones are released into the bloodstream and then travel to the organs and tissues where they are needed. This process of direct skin absorption of the hormone also means that lower doses of hormone can be used to achieve the same effects, which can be a safer route for some patients. Another benefit of bypassing your gastrointestinal tract is a lower risk of causing gallbladder disease or the need for gallbladder removal than when taking oral hormone replacement.
During the menopause transition, a woman’s estrogen production in the ovaries significantly declines. Estrogen works to protect a woman’s cardiovascular health, her bone health, and ultimately helps all tissues in a woman’s body function at its best. Taking a systemic estrogen replacement helps replace the estrogen that is no longer being produced by the ovaries, but is still very much needed by the body. Estrogen replacement therapy via an estradiol patch also prevents bone loss that occurs in early menopause that can lead to osteoporosis. In preventing osteoporosis, the estradiol patch, like other forms of HRT, can also help prevent hip and spine fractures for women later in life.
Side Effects of Hormone Patches
Every medication or supplement can have unwanted side effects. For patches, the most common side effect is local skin irritation at the site where the patch is applied. If you are a patient who normally has very sensitive skin or reacts negatively to the adhesives on bandaids, then patches may not be the best option for you. Other hormone patch side effects mirror common side effects of all hormone replacement therapy. These can include, but are not limited to, vaginal bleeding, vaginal discharge, breast tenderness, nausea, constipation, bloating, headaches, or mood swings. Most of these side effects occur as you begin treatment and may resolve on their own with time.
Other Considerations Before Choosing a Hormone Patch
Generally, we recommend placing the estradiol patch on an area of skin on your torso or below the waist that is obscured by clothing; they should not be applied to the breasts. Heat can make some patches release their estrogen too quickly, which can affect the dosage you receive, so it is recommended that you not use tanning beds or saunas while wearing an estrogen patch. Patches should not be exposed to other high heat or direct sunlight. The hormone patch should be applied to clean, dry skin. If you are someone who regularly applies body lotions or creams, you should not attempt to place a patch after applying moisturizer. It may affect how well the patch adheres to your skin and how the medication from the patch is absorbed.
The Best Method for You
The best hormone therapy is the one that fits into your lifestyle. If you have any underlying medical conditions, you and your doctor can choose the method that is not only the most convenient but also the safest for your body. Here at Winona, we know that everyone is unique, and we offer estradiol patches in various different strengths. The patch is a great option for many of our patients - find out if it’s the right choice for you!
Racine A, Bijon A, Fournier A, et al. Menopausal hormone therapy and risk of cholecystectomy: a prospective study based on the French E3N cohort. CMAJ 2013;185:555-61. 2.
Liu B, Beral V, Balkwill A, et al.; Million Women Study Collaborators. Gallbladder disease and use of transdermal versus oral hormone replacement therapy in postmenopausal women: prospective cohort study. BMJ 2008;337:a386