HRT- Estraderm

Different Forms of HRT: Estraderm

(transdermal estradiol patch)

The Estraderm patch was the first widely available estrogen patch and is still one of the most widely used. It comes in both 50 mcg and 100 mcg dosages, with the 50 mcg patch being the most commonly prescribed initally.

These are reservoir patches -- transparent ovals with adhesive like a Band-Aid, and a fluid reservoir like a bubble in the middle. This bubble contains the estrogen which is transmitted through your skin. You just apply it to unexposed skin -- your buttocks, thighs or lower abdomen -- and forget about it until it’s time to change it, which you do every 3 ½ to 4 days. It usually takes less than four hours to reach the therapeutic level of estrogen in your system and, as with other patches, the estrogen is delivered continuously to your body.

It’s a nice and easy way to get estrogen -- plus you get the benefits of bypassing your liver and getting a steady, continuous dosage of estrogen into your system. But, unfortunately, it’s not always as great as it sounds. First, there’s something about the adhesive in the Estraderm patch that apparently causes skin irritation -- especially if you use it in more sensitive areas, such as your lower abdomen. About 15 to 20 percent of the women using the Estraderm patch develop blotches and welts under and around the patch. You may be able to get around this, though, by moving the patch to less sensitive skin areas, such as the buttocks or thighs. In addition, using vitamin E or cortisone cream may help soothe the irritated skin. But according to the manufacturer, at least 2 percent of Estraderm users stop using the patch because of skin irritation. The second problem that a number of Estraderm users have reported: The edges often get rolled, less "stick-able" and generally messy. This isn’t a huge problem, but it can get annoying -- and sometimes embarrassing if the patch suddenly stops sticking at an inopportune moment.

Standard dosage: 50 mcg (.05 mg); also available in a higher dosage -- 100 mcg (1.0 mg)

Pros: Easy to use; a good choice for smokers -- as studies have indicated that oral estrogen may not deliver the same amount of estrogen to smokers as non-smokers, while patches don't appear to have this same problem

Cons: Skin irritation under and around the patch is common