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Transdermal Estrogen
Aka: Transdermal Estrogen, Estraderm, Estrasorb, Transdermal Estradiol, Evanmist, Estrogel, Elestrin, Divigel, Vivelle Dot, Minivelle
- See Also
- Menopause
- Estrogen Replacement
- Continuous Estrogen Replacement
- Sequential Estrogen Replacement
- Vaginal Estrogen
- Indications
- Osteoporosis Prevention in postmenopausal women (Estraderm or Estrasorb)
- As of 2015, Estrogen is not recommended by ACOG or AAFP for chronic condition prevention
- Hot Flashes (Evanmist, Estrogel, Elestrin, Divigel)
- Advantages
- Studies suggest no increased Thromboembolism risk
- Scarabin (2003) Lancet 362:428-32 [PubMed]
- Efficacy: Osteoporosis Prevention (Estraderm or Estrasorb)
- Placebo
- Hip BMD: 2.04% loss
- Lumbar Spine BMD: 2.49% loss
- Dose: 0.025 mg Estradiol patch
- Hip BMD: 0.26% gain
- Lumbar Spine BMD: 2.37% gain
- Dose: 0.05 mg Estradiol patch
- Hip BMD: 2.85% gain
- Lumbar Spine BMD: 4.09% gain
- Dose: 0.06 mg Estradiol patch
- Hip BMD: 3.05% gain
- Lumbar Spine BMD: 3.28% gain
- Dose: 0.1 mg Estradiol patch
- Hip BMD: 2.03% gain
- Lumbar Spine BMD: 4.70% gain
- References
- Weiss (1999) Obstet Gynecol 94:330-6 [PubMed]
- Preparations: Transdermal Combination Progesterone and Estrogen
- Activella (17B-Estradiol-Norethindrone Acetate)
- Contains 1 mg Estradiol with 0.5 mg Norethindrone
- Climara Pro (17B-Estradiol-Levonorgestrel)
- Patch contains 0.045 mg Estradiol with 0.015 Levonorgestrel
- Patch applied weekly
- Combipatch (17B-Estradiol-Norethindrone Acetate)
- Patch contains 0.05 mg Estradiol with 0.014 or 0.25 mg Norethindrone
- Patch applied twice weekly
- Preparations: Agents used for Osteoporosis (Transdermal Estradiol)
- Preparations must be taken with Progesterone if Uterus intact (Endometrial Hyperplasia risk)
- See Continuous Estrogen Replacement
- See Sequential Estrogen Replacement
- Estrasorb (Transdermal Estradiol)
- Two foil packs equivalent to 0.05 mg Estradiol
- Rub one packet on right top of thigh, back of calf
- Repeat with second packet on left leg
- Do not apply with Sunscreen (increases absorption)
- Estraderm (Transdermal Estradiol Patch)
- Dosing: 0.05 mg Estradiol
- Change patch twice weekly using a different site
- Apply to non-irritated skin
- Lower Abdomen
- Buttock
- Do not apply to Breast
- Preparations: Agents used for Menopausal Hot Flashes (Transdermal Estradiol)
- Preparations must be taken with Progesterone if Uterus intact (Endometrial Hyperplasia risk)
- See Continuous Estrogen Replacement
- See Sequential Estrogen Replacement
- Evanmist
- Dosing: 1-3 sprays per day on inner Forearm to adjacent areas (not overlapping)
- Allow skin to dry for 30 minutes
- Estrogel (0.06% Estradiol)
- Pump delivers 0.75 mg of Estradiol (64 actuations per device)
- Apply gel from one wrist to the Shoulder, spreading thinly
- Elestrin (0.06% Estradiol)
- Pump delivers 0.52 mg of Estradiol (100 actuations per device)
- Apply to upper arm and Shoulder
- Allow to dry for 2 hours before immersing in water (e.g. swimming)
- Divigel (0.1% Estradiol)
- Foil packet delivers either 0.25 mg, 0.5 mg or 1.0 mg Estradiol per packet
- Apply packet contents to one upper thigh (5x7 inch area)
- Alternate to opposite side on subsequent application days
- Allow to dry for 1 hour before washing the area
- References
- Filer (1994) Am Fam Physician 49(7):1639-42 [PubMed]
- Hill (2016) Am Fam Physician 94(11): 884-9 [PubMed]