You may have heard about estrogen spray. Here we cover the basics and explain what it is and how to use it.
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What is HT spray?
Hormone therapy (HT) is an effective treatment for menopause symptoms including hot flashes, poor sleep, and mood changes. Several different types are available, including oral HT (tablets) and transdermal HT, such as patches and gels.
HT spray is a newer type of transdermal estrogen HT. The spray is applied to your skin and from there absorbed directly into your bloodstream.
The spray contains estradiol, a type of estrogen that can help relieve your menopause symptoms.
Right now the only brand of HT spray available in the US is Evamist.
Learn more about the different types of HT.
How does it work?
During perimenopause and postmenopause, your estrogen levels start to fluctuate and eventually fall. For many people this causes menopause symptoms, which can include hot flashes, poor sleep, and mood changes, among others.
HT works by supplying your body with the estrogen it no longer produces. HT spray works in this way too. Estradiol is sprayed onto your skin, absorbed into your bloodstream, and distributed around your body.
How do you use HT spray?
The leaflet in your HT spray package contains full instructions. As a general guide:
- Apply the spray to clean, dry skin
- The best place is the inner part of your forearm. If this isn’t possible, apply to your inner thigh. Choose an area of skin free from rashes or skin problems, as these can affect the absorption
- Do not apply the spray to the breasts or genital area
- Hold the applicator to your skin. One press delivers one dose of estrogen. If you need a second or third spray, apply this to a different patch of skin
- Let the spray dry for two minutes before getting dressed. Avoid bathing or washing for at least an hour. Avoid physical contact with others at least until the spray has dried
Most people begin by taking one spray per day, but your healthcare provider may advise increasing this if needed. It can take a while for HT to work fully, so ask your healthcare provider before taking more than prescribed.
If you still have your uterus, you will also need to take some form of progesterone. This is because taking estrogen alone can lead to abnormal thickening of the uterine lining, and in some cases even cancer. Thankfully, using progesterone removes this risk. Progesterone is available in a number of different forms including tablets, combined patches, and hormonal IUDs. Your healthcare provider will be able to advise which options are available for you.
Worried that your HT might not be working for you? Find out more about side effects and what to do if you’re not feeling better.
What are the benefits of HT spray?
HT spray is an effective way to control your menopause symptoms. It also provides other benefits of HT, including helping to prevent osteoporosis. It is popular for a number of reasons.
- Like other forms of transdermal HT such as patches and gels, HT spray is not thought to come with any increased risk of serious blood clots
- Your dose can be easily adjusted if needed
- You do not need to wear a patch or worry about it falling off
- It is easy to apply and dries quickly
What are the side effects of HT spray?
Like all medications, HT spray can cause side effects. These include:
- Sore breasts
- Bloating
- Nausea
- Cramps
- Indigestion
- Irregular vaginal bleeding
These usually settle within 6-12 weeks of starting treatment. If they persist or are severe, see your healthcare provider. They might advise you to try a different dosage or type of estrogen.
See your healthcare provider urgently if you experience any of the following:
- Vaginal bleeding if it has been over a year since your last period
- Bleeding after sex
- Breast lumps or other concerning breast changes – read how to check your breasts
- Any severe pain
- Any leg swelling, tenderness, or redness
- Any other persistent, severe, or worrying symptoms
What are the risks of HT spray?
Like all medications, HT comes with a few risks as well as benefits. Your risk profile takes into account your medical history and any other medications you use alongside the spray, for example progesterone if you take combined HT.
HT spray is not thought to increase your risk of serious blood clots like pulmonary embolism or deep vein thrombosis, which is collectively known as venous thromboembolism or VTE. Despite this, if you have risk factors that put you at higher risk of these conditions, including a strong family history or a BMI over 45, you may need to see a specialist for HT to be prescribed.
Read more about the risks and benefits of HT.
Should I use estrogen spray or gel?
This is a personal choice, but it also depends on product availability where you live. Both the gel and the spray are thought to come with the same benefits, risks, and side effects.
Consider:
- How satisfied you are with the application and absorption
- Cost differences
- Supply issues
Your healthcare provider will be able to advise you further if needed.
Final word
HT spray is a popular and convenient way to relieve menopause symptoms. Speak to your healthcare provider if you would like to find out more.
Find out more about menopause on our blog or in our symptoms library.
