Transdermal 17β-oestradiol

About this product

Transdermal 17-beta-oestradiol is delivered either as an adhesive patch changed once or twice weekly, as a gel applied to the skin daily, or as a metered spray (Lenzetto), depending on the formulation prescribed. It is licensed in the UK for the treatment of menopausal symptoms (hot flushes, night sweats, mood changes, sleep disturbance, urogenital symptoms) and for the prevention of postmenopausal osteoporosis in women at increased risk. In women with an intact uterus, oestrogen must be combined with a progestogen (continuous or sequential, depending on cycle status) to protect the endometrium; this is a clinical decision made at consultation. Contraindications per the Estradot, Oestrogel and Evorel SmPCs include known, past or suspected breast cancer; known or suspected oestrogen-dependent malignant tumours (e.g. endometrial cancer); undiagnosed genital bleeding; untreated endometrial hyperplasia; previous or current venous thromboembolism (deep vein thrombosis, pulmonary embolism); known thrombophilic disorders (e.g. protein C, protein S or antithrombin deficiency); active or recent arterial thromboembolic disease (e.g. angina, myocardial infarction); acute liver disease, or a history of liver disease as long as liver function tests have failed to return to normal; porphyria; and known hypersensitivity to oestradiol or any excipients. The transdermal route is associated with a lower risk of venous thromboembolism than oral oestrogen; NICE NG23 recommendation 1.5.28 advises clinicians to consider transdermal rather than oral HRT for people with menopause-associated symptoms who are at increased risk of VTE, including those with a BMI over 30 kg/m2, and BMS guidance recommends transdermal where VTE, stroke or cardiovascular risk factors are present. For women without these risk factors, route is a shared decision based on symptoms and preference. The prescribing clinician will discuss benefits, risks (including the breast cancer risk relevant to your individual profile and the duration of therapy), monitoring requirements and review cadence before any prescription is issued. WMG Meds offers this option as part of its hormone-related private prescribing service; suitability is determined entirely by the GMC-registered prescriber following a full menopause-focused clinical assessment, in line with the BMS and NICE NG23 frameworks.

How it works

Transdermal 17-beta-oestradiol replaces the oestrogen lost at menopause. It binds to oestrogen receptors throughout the body and reverses the vasomotor (hot flushes, night sweats), urogenital, mood and sleep effects of oestrogen deficiency, and reduces bone resorption. The transdermal route bypasses first-pass hepatic metabolism, which is why it carries a lower VTE risk than oral oestrogen.

Who this product is for

• You are a woman in perimenopause or postmenopause with bothersome symptoms
• You have a clinical indication for hormone replacement therapy following assessment
• You prefer the transdermal route (lower VTE risk vs oral oestrogen)
• You have no current contraindications and are willing to attend regular review