HRT (Oestrogen) Patches

There is no strong evidence that oestrogen patches cause weight gain. Some women notice changes in body shape or mild bloating when starting HRT, but this is usually due to fluid retention and settles over time. Oestrogen may actually help prevent the increase in abdominal fat linked to menopause.

Oestrogen patches should be applied to a clean, dry, hair-free area below the waist—usually on the lower abdomen or buttocks. They should not be placed on or near the breasts. Rotating the application site can help prevent skin irritation.

Both are effective, and the choice depends on personal preference:

• Patches: Provide a steady hormone release, require less daily effort, and may be more convenient for some women.
• Gel: Allows for more dose flexibility and avoids potential skin irritation from patches, but needs to dry before dressing.

Both bypass the liver, making them a good option for women who cannot take oral HRT.

It depends on the type of HRT:

• Sequential (cyclical) HRT – Used in perimenopause, includes progesterone for part of the month, and leads to a monthly withdrawal bleed.
• Continuous combined HRT – Used after menopause (12 months without a period) and should not cause regular bleeding, though some spotting can occur in the first few months.

To keep patches in place:

• Apply to clean, dry skin (avoid lotions or oils).
• Choose a low-friction area like the lower abdomen or buttocks.
• Press firmly for at least 10 seconds when applying.
• If sweating or swimming frequently, a clear dressing over the patch can help keep it secure.

The lower body has better absorption for the hormone and avoids breast tissue, reducing any unnecessary exposure to oestrogen. This placement also helps keep hormone levels stable.

Most women tolerate patches well, but some may experience:

• Skin irritation at the patch site
• Breast tenderness
• Mild bloating or fluid retention
• Headaches (usually temporary)
• Breakthrough bleeding in the first few months (if on combined HRT)

Side effects often settle with time, but if they persist, adjusting the dose or type of HRT may help.