Oestrogen patches

Oestrogen patches are used as menopausal hormone therapy (MHT) to replace oestrogen. At menopause, and during the time leading up to it (peri-menopause), your ovaries start to make less oestrogen. A decrease in oestrogen levels can cause symptoms such as hot flushes, vaginal dryness, and mood and sleep changes.

Using hormone therapy to replace oestrogen can help to relieve some of the symptoms of menopause and can make a big difference to some people's enjoyment of life. Read more about the types and stages of menopause and the signs of menopause.

If you still have your uterus

If you still have your uterus, your menopausal hormone therapy will include both oestrogen and progesterone, so oestrogen patches will be used together with a progestogen. This is because oestrogen alone can overstimulate the cells lining your uterus, causing an increased risk of cancer of the uterus lining. Taking progesterone alongside oestrogen helps to prevent this.

How long should I continue oestrogen therapy for?

• Every person is different and the length of time you'll have menopausal symptoms is unknown.
• People who go through menopause before 45 years of age are advised to take oestrogen therapy until the average age of menopause – about 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.

Oestrogen gender affirming hormone therapy (E-GAHT) is used by some transgender and non-binary people to help align their body with their gender.

E-GAHT is 2 types of medicines – a form of oestrogen and a medicine to block testosterone. Both are needed unless you've had surgical removal of your testicles (in which case a testosterone blocker isn't usually needed).

• E-GAHT can be used by trans women or non-binary people for gender feminising effects such as breast development, softer skin and reduced oiliness, decreased muscle mass and strength, less body hair, etc
• Oestrogen patches may work as well as tablets but have fewer side effects. Read more about E-GAHT.

• Placement of the patch: 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, irritated or inflammed (red) or folds.  
• Before applying the patch: Remove an old patch before applying a new patch. Make sure your skin is clean and dry. Don't apply the patch to oily, broken or irritated skin. 
• When applying the new patch: Press the patch firmly in place for about 10 seconds. Make sure the patch sticks well, especially around the edges. Don't put the patch on the same area of skin for the next few applications.

Cutting patches

Ideally, patches shouldn't be cut but, due to supply issues and shortages, it's sometimes necessary to cut them. Your pharmacist will tell you if your patch can be cut and if the rest of the patch can be used later. Here is some guidance when cutting patches:

• Cut the patch diagonally from corner to corner. For round patches, fold in half and cut along the folded line.
• If the other half can be used for the next dose, store it in an airtight plastic bag at room temperature for up to 1 month.

Other tips

• Some procedures such as an MRI scan may overheat the patch and burn your 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.

Oestrogen gel, patches or tablets are not suitable for everyone.

To make sure they're safe for you, tell your healthcare provider if you:

• have ever had breast cancer, are having tests for breast cancer, or are considered high risk due to family history
• have ever had any other type of cancer
• have ever had a blood clot in a vein (thrombosis), such as in your legs (deep vein thrombosis) or lungs (pulmonary embolism)
• have ever had angina or a heart attack
• have vaginal bleeding with no known cause
• have thrombophilia, a condition that increases the risk of blood clots
• have liver problems
• have migraines or severe headaches.

Common side effects

Some people may have headaches, breast tenderness or pain, feel sick (nausea), experience mood changes and weight changes. If these things happen to you, contact your doctor for advice.

Serious side effects

Serious side effects from oestrogen patches are rare.

Get immediate medical advice if you get these symptoms:

• Pain, redness or swelling in one of your legs, usually in your calf. This could be a sign of deep vein thrombosis (DVT).
• Tummy pain, your skin and eyes turning a yellow colour, itchy skin, dark coloured pee, pale coloured poo. These could be signs of problems with your liver.
• A sudden rash or signs of anaphylaxis, such as swelling of your face or lips. 

Tell your healthcare provider if you get the following symptoms:

• A lump or changes in your breasts, especially dimpling of the skin, changes in the nipple or any lumps you can see or feel.
• Any changes in vaginal bleeding after you have been taking oestrogen for more than a few months.