There are a number of different ways to deliver oestrogen replacement to the body.
Oral tablets, patches, gels and sprays are the most commonly used methods in the UK.
We prefer to prescribe what we call ‘transdermal’ oestrogen, which is oestrogen that is delivered via the skin into the bloodstream. This is the safest delivery method, either as a gel, a patch or a spray. Transdermal oestrogen appears to have little or no impact on clotting factors and so can be used safely in women with a history of blood clotting or migraines.
They are all excellent delivery methods, so it’s up to you how you prefer to receive oestrogen. This will be dependent on the ease of use or lifestyle factors.
Patches are useful because they are applied as a translucent plaster placed below the waist, to the hip, outer thigh, lower tummy or bottom and only changed twice a week. They can be worn in the bath or shower or to swim, delivering a specific continuous dose. They come in varying strengths but the dose is harder to alter. Some women find the patches irritating, react to the glue, or have sticking problems, whereas other women really find patches very easy to use, often forgetting about them entirely between changes.
The gel and the spray can be modified according to patient symptoms. This is particularly useful for patients who want to start at a very low dose and work their way up. Gels and sprays are applied daily, usually in the morning, and allowed to dry fully before dressing.
Tablets can be convenient and are still widely prescribed in the UK – especially when other risk factors are low, if you have skin problems such as widespread eczema, or if you struggle to absorb transdermal products.
There’s also a new body identical tablet called Bijuve which is suitable for postmenopausal women and contains body identical oestrogen and progesterone.
Lenzetto Spray
Lenzetto is a body identical oestrogen product.
It is an easy to use, daily spray. Apply it to the forearm or inner thigh and it dries quickly.
Each device contains 56 sprays.
Women should avoid swimming or bathing within the first few hours of using it.
In women who still have a womb, it needs to be used alongside progesterone to provide endometrial protection.
Oestrogel delivers a metered dose of oestrogen from a pump. The dose is applied to the outer upper arms, shoulders or inner thighs every morning and allowed to try. Each pump contains 64 doses. It is used alongside progesterone in women who still have their womb.
Oestrogel is a body identical oestrogen product. It is easy to use and comes as a gel that is applied to the arms and legs.
Sandrena Gel is similar to oestrogel but comes as sachets in two different strengths so you can choose your dose. It is applied daily to upper outer arms or the inner thighs. Progesterone must be prescribed in addition for women who have not had a hysterectomy.
Estradot is a brand of oestrogen-only patch and comes in several different strengths. It is soft, small and often sticks well. Progesterone must also be prescribed for women who still have a uterus. You apply it to the skin on your hip, thigh or bottom and change your patch twice weekly.
Evorel Sequi and Conti Patches come as oestrogen-only or a combined product containing body identical oestrogen with a synthetic type of progesterone. You apply it to the skin on your hip, thigh or bottom and change your patch twice weekly.
