Oestrogen patches for menopausal hormone therapy

Oestrogen patches are used as menopausal hormone therapy (MHT) to replace oestrogen. Your ovaries are no longer making oestrogen during perimenopause and after menopause. The hormone from the patch is absorbed through the skin and into the body to prevent and manage menopausal symptoms. Read more about menopausal hormone therapy (MHT).

If you haven't had a hysterectomy (operation to remove the uterus), you must take another type of hormone called a progestogen as well as using the oestrogen patches. Adding progestogen helps to protect the lining of the uterus. If you haven't been asked to take a progestogen, talk to your doctor.  

Note: Oestrogen is also available as tablets or vaginal cream or pessaries. The information on this page is only about oestrogen skin patches. Read more about oestrogen vaginal cream or pessaries or oestrogen tablets. 

In Aotearoa New Zealand examples of oestrogen patches include Estradot, Climara, Estraderm MX.

• Oestrogen patches are available in different strengths..
• The strength of the patch will depend on the severity of your symptoms. Your healthcare provider will advise you on the best dose for you.
• Some patches, such as Climara are applied once a week, every 7 days.
• Some patches such as Estradot and Estraderm MX are applied twice a week, every 3 or 4 days.
• It takes a few weeks before you notice improvement in your menopausal symptoms after treatment with an oestrogen patch. But this can vary from person to person.

Pros

Oestrogen patches are effective in reducing menopausal symptoms. They are convenient because they only need to be applied once or twice a week and you don't have to remember to take a pill every day. The risk of some side effects such as blood clots is lower with patches compared with oestrogen tablets.  

Cons

The patch works well for many people, but it may not be a suitable option if you swim frequently, sweat profusely, or soak in hot tubs and baths. Also, the patch itself might irritate the skin where you apply it.

• The best place to apply oestrogen patches is on your lower abdomen (tummy/puku) or buttocks. Don't apply the patch to your breasts. Don't put the patch on your waistline where tight clothes may rub it. Avoid putting the patch on areas where the skin is hairy or folded.
• Before applying the patch, make sure your skin is clean and dry. Don't apply the patch to oily, broken or irritated skin. Press the patch firmly in place for about 10 seconds. Make sure the patch sticks well, especially around the edges.
• When applying the new patch, remove the old patch and put the new patch on a different area. Don't put the patch on the same area of skin for the next few applications.
• If your patch falls off put on a new patch.

Tips

• Don't tear or cut oestrogen patches.
• Some procedures such as an MRI scan may overheat the patch and burn the skin. Talk to your healthcare provider before your procedure.
• Avoid lotions or perfumes on areas where you stick your patch as it may stop the patch from sticking properly.
• Read more about the safe use of medicine patches.

Every person is different and the length of time you'll have menopausal symptoms is unknown.

People who go through menopause before 45 years are advised to take oestrogen therapy until the average age of menopause – around 50 years of age.

It’s important to have regular check-ups with your doctor to assess whether ongoing oestrogen is right for you. Most people stop taking it after a few years, when their symptoms resolve. It's usually best to reduce menopausal hormone therapy gradually rather than stopping it suddenly. This may reduce the risk of menopause symptoms returning.

The following links have more information on MHT. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.

Menopause(external link) Family Planning, New Zealand 
Menopause health information(external link) Australasian Menopause Society
Menopause and HRT(external link)  Patient Info, UK

Menopause
Menopausal hormone therapy
Menopausal non-hormone therapy

1. Oestrogen only menopausal hormone therapy(external link) Australasian Menopause Society
2. Estrogens and management of menopausal symptoms(external link) New Zealand Formulary