Many people use hormone therapy (HT) patches to help reduce their menopause symptoms, but how do they work and what are the pros and cons? Read on to find out everything you need to know.
What are HT patches?
HT patches are a type of transdermal hormone therapy (HT). This means that they help with your menopause symptoms by supplying hormones to your body through your skin. They contain estrogen and sometimes progesterone too. These are known as estrogen-only and combined HT patches respectively.
How do HT patches work?
Each patch contains a specific dose of hormones. The patch is placed on your body and delivers medication by diffusing through your skin and into your bloodstream. A specialized adhesive allows it to stay in place for three days at a time.
The hormones enter your bloodstream through tiny blood vessels below the patch and then circulate throughout your body, where they get to work relieving your symptoms.
Patches contain estrogen – which is needed to relieve your menopause symptoms – and sometimes progesterone too.
If you still have your uterus, you will need to take a patch that combines both estrogen and progesterone. This is because if used alone, estrogen can cause abnormal thickening and even cancer of the uterus lining, also known as the endometrium. Taking progesterone alongside estrogen protects the uterus lining and removes this risk.
Benefits of HT patches
HT is the most effective treatment available for menopause symptoms, including hot flashes, disturbed sleep, and mood changes. HT has other beneficial effects, including the prevention of osteoporosis – thinning of the bones – and for some women a reduction in the risk of cardiovascular disease.
HT patches are an alternative to HT tablets and have a few benefits.
- Patches are convenient and easy to use; you just need to stick a new patch on your skin every few days. If you struggle to remember to take daily tablets or are unable to take medication by mouth, then patches could be a good option for you.
- Patches are often preferred to pills by healthcare providers because they come with fewer risks, including fewer risks of blood clots or venous thromboembolism. This means that patches may be suitable for you even if you have medical conditions or other risk factors that make HT tablets risky
- The delivery of hormones is nearly constant throughout the life of the patch, whereas with pills, hormone delivery to the blood peaks and then declines each day. Constant delivery can help minimize side effects
How do you use HT patches?
When you open the packaging, remove your patch and carefully apply it to a clean, dry area of skin, making sure the skin is also free from oils before application. Rotating the location of your patch is sometimes helpful. If you suffer from any skin conditions, avoid applying the patch to affected areas of skin, as this can affect absorption.
For full instructions, see the leaflet in your pack.
Where is the best location for the HT patch?
The HT patch should be applied to a hairless area below your waist. For many people, this means applying the patch to your buttocks or thighs, although the lower abdomen is another option.
Do not apply the patch on or near your breasts.
Avoid placing the patch under tight waistbands or in other places where your clothing could rub and cause it to fall off. You should also avoid applying it over areas with a lot of hair, as this can increase the risk of the patch falling off, and make removing it more difficult too.
What are the side effects of HT patches?
This depends on the type of hormone in your patch – whether it is estrogen-only or a combination of estrogen and progesterone.
Side effects of estrogen can include:
- Sore breasts
- Bloating
- Nausea
- Cramps
- Indigestion
- Irregular vaginal bleeding
Additional side effects that may be associated with progesterone can include:
- Headaches
- Acne
- Mood changes and depression
These usually settle within the first six weeks of starting treatment. If they are severe or persistent, see your healthcare provider. They may be able to advise a change in the dose or type of hormone in your HT.
Skin patches specifically may also cause skin irritation due to the adhesives used. If this happens, your healthcare provider may be able to suggest an alternative product such as an estrogen gel or spray.
See your healthcare provider urgently if you have any:
- Vaginal bleeding if it has been over one year since your last period
- Bleeding after sex
- Breast lumps or other changes in your breasts – read how to check your breasts
- Any severe pain
- Any unusual headaches, including headaches that have any associated symptoms like vision changes, dizziness, or other sensory changes
- Any leg swelling, tenderness, or redness
- Any other persistent, severe, or worrying symptoms
What are the risks of HT patches?
This depends on the type of hormone contained in your patch and your medical history.
Patches are generally a lower-risk way of taking HT when compared to tablets. They are not thought to increase your risk of serious blood clots in the same way that oral HT does.
However, patches that contain progesterone can cause a slight increase in your risk of breast cancer. For a thousand women using this type of HT over a five-year period, an extra four cases of breast cancer will be diagnosed when compared to those not on HT. This is thought to be about the same risk as progesterone taken orally.
To put this into context, an additional five cases would be diagnosed among those same thousand women if they all drank two or more units of alcohol per day. An additional 24 cases per thousand would be diagnosed if all of the women were overweight or obese.
This risk falls after stopping HT – after five years, risk returns to baseline.
Estrogen-only HT patches when used without progesterone are not associated with an increased risk of breast cancer.
Read more about HT, breast cancer, and your family history.
What are the best HT patches?
There is no single best HT patch – the best patch is the one that works for you!
Your healthcare provider will guide you to choose the best HT patch for your needs. There are a range of doses available, and it can sometimes take a while to find the best prescription for you.
If you like the idea of transdermal HT but can’t find the right patch, you might try a gel or a spray.
Final word
HT patches are a convenient and safe way to take HT. Speak to your healthcare provider to find out more about your options.
Find out more about menopause on our blog or in our symptoms library.
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