Transdermal Hormone Therapy


transdermal hormone therapy


Transdermal menopause hormone therapy is administered through the skin using patches, gels, creams, and sprays. This treatment absorbs estrogen and sometimes progestin (if necessary) directly into the bloodstream. The hormones penetrate the skin barrier and enter the blood vessels, ensuring a steady absorption into the bloodstream. It's available in:


Patches


  • Applied on a clean and dry skin of the lower abdomen, upper thighs, and buttocks.

  • Changed according to the prescribed schedule.


Gel and Cream

  • Applied daily on arms, legs, shoulders, or abdomen.

  • Requires drying time before covering with clothing to ensure proper absorption.


Spray

  • Applied daily through metered-dose spray on the forearm (between the elbow and the wrist) and inner thigh.

  • Requires drying time before covering with clothing to ensure proper absorption.


Transdermal Efficacy

Transdermal menopause hormone therapy benefits the liver and digestive system because it bypasses first-pass metabolism in the liver and avoids direct interaction with the gastrointestinal tract. This ensures steady release of hormones and avoids hormone level fluctuations.


Oral hormone therapy passes through the stomach and intestine where it is processed. It reduces its effectiveness and causes unsteady hormone doses, contributing to hormonal fluctuation. Also, transdermal MHT lessens potential stomach irritation, nausea, and bloating compared to oral MHT.


Additionally, transdermal therapy has less impact on liver-produced proteins because of bypassing the first-pass metabolism. For this, it reduces blood clotting, inflammation, and maintains SHBG levels (sex hormone-binding globulin). 


Sex hormone-binding globulin is a protein made mostly in the liver. It controls the amount of sex hormones that are actively working in the body. An undisrupted SHBG production has stable free estrogen and testosterone levels. This maintains natural hormone balance that leads to:


  • Reduced mood swings and hot flashes

  • Supports energy, sex drive, and muscle health


The combined clinical studies of Gynecology, Obstetrics, and Neonatology institutes and universities in Spain showed that a dose of 0.025 mg/day reduced hot flashes frequency by 84%. Additionally, transdermal estradiol increased the bone mineral density at the spine and hip. However, experts don’t recommend this therapy for osteoporosis prevention. 


Moreover, KEEPS (Kronos Early Estrogen Prevention Study) noted that transdermal estrogen is good for younger women’s sleep and cognition ability in their postmenopausal years (women aged 42-58 years who are within 36 months of their final menstrual period).


Availability


Transdermal menopause hormone therapy products are licensed in most European countries, North America, Australia, New Zealand, and several Asian countries (China, India, and Pakistan).


Transdermal Side Effects


50% to 60% of users reported skin reactions. These are mild-to-moderate redness, irritation, and itching on the site where patch, gel, and cream are applied. Women experience breast tenderness due to estrogen dosage and abnormal bleeding for most non-hysterectomized women are reported.


Despite its favorable safety profile and lower associated serious health risks, users may experience transdermal menopause hormone therapy side effects. Constant medical supervision is recommended to check the changes, side effects, and its efficacy.


Sources


Transdermal Estrogen Benefits Cognitive Functioning in Perimenopausal Women

Is transdermal menopausal hormone therapy a safer option than oral therapy?

Clinical Efficacy of Estradiol Transdermal System in the Treatment of Hot Flashes in Postmenopausal Women









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