Everything you need to know about estrogen patches for HRT.
Illustrations by Leo Mateus.
Estradiol transdermal patches are one way for transgender, non-binary, and gender-fluid people to take estrogen for gender feminizing hormone replacement therapy. These patches are placed on the skin of the body and release estrogen hormone over a gradual period of time.
Transgender and non-binary people looking to change their gender through estrogen replacement therapy may choose estradiol patches because of their ease and safety.The easy-to-use skin patch is applied to the skin like a sticker and delivers estradiol through the skin and directly into the bloodstream. Compared to injections, hormone levels fluctuate less with patches and the absorption of hormones through the skin makes it safer for people who are at risk for blood clots. Some common brand names of estrogen patches are Climara, Alora, and Vivelle-Dot.
The side effects of estradiol patches themselves are minimal, but will still contain the common side effects of estrogen as a hormone. The main concern with transdermal patches is that they are more likely to fall off due to sweat, showering or bathing, or through friction with clothes.
If you're considering using transdermal patches for your estrogen hormone therapy, it's important to know that the patches only go up to a certain dose. Increasing the dose means using additional patches- up to a maximum of four patches at a time. For those who are using twice per week patches, that means eight patches in a week, and 24 in a month!
If you're curious about the difference between estrogen patches, oral estradiol, and injectable estradiol, check out this article.
When you first start your estrogen HRT journey, you might feel an increased sense of comfort and ease within yourself. This can be an exciting new time, and you might be feeling a range of emotions. Many trans women and transfeminine people report feelings of more joy and overall wellbeing, as well as an increase in self-confidence. Alongside these positive changes, there are some side effects that you should be aware of when taking estrogen.
The major side effects of estrogen to keep an eye on are blood clots, heart attacks, and strokes. Your provider can help you better understand the likelihood of these concerns. Other less common side effects of estrogen include: increased fat and/or cholesterol in the blood, increased blood pressure, increased risk of diabetes, and headaches. If your family has a history of heart disease, liver disease, kidney disease, severe headaches, or gallbladder disease, consult your provider before starting estrogen HRT therapy. For more information on estrogen and its side effects, check out this article.
The common effects of estrogen HRT include physical changes such as breast growth, softening of the skin, thinning or slowed hair growth on the face or body, body fat redistribution and hips and thighs, and decreased muscle mass and strength.
Some estrogen patches are changed once a week, while others are changed twice a week. Either way, patches can still pose a few problems when it comes to adhesives. But we've got you covered with a few ways to make it easier.
Estrogen patches stick best when placed on clean, dry skin on a relatively flat area that doesn’t tend to sweat heaps or have a tons of dense hair. It’s also best to avoid any bony or bendy areas like an elbow or a knee.
Common locations to apply estrogen patches are generally:
There are a few things to watch out for when applying patches:
Try not to use the same spot for at least a week after taking a patch off. Some skin irritation or redness under the patch is common after removed, which is why switching spots can be helpful.
Estrogen patches are waterproof, and although they can be used in the shower or during a particularly sweaty workout, they tend to stop sticking well after a few days. If a patch isn’t sticking to the body for the duration of time the prescription has stated, there are a few tips and tricks:
If an estrogen patch comes off completely, first try to re-apply it to a new clean, dry spot if it has some stickiness left. If it is no longer sticky, use a new patch. If you end up using more patches because they’re not sticky enough, make sure to let a provider know, as this may lead to needing a refill early.
Estradiol transdermal patches are not exclusive to HRT for transgender people and have also been used to treat conditions related to decreased estrogen levels in the body including menopause (hot flashes, sweating, and spontaneous feeling of warmth in the body), osteoporosis, and vaginal dryness, itchiness, or irritation. Some younger cis women who do not produce enough estrogen naturally will also use estradiol patches to supplement their baseline levels.
Some brands of estradiol patches, like CombiPatch, that include estrogen and progestin (a synthetic progesterone) are often used to treat severe symptoms related to menopause. The progestin acts to reduce the risk of uterine cancer which is related to increased estrogen levels.
Most brand name estradiol patches will come in 100mcg doses which lasts for three to four days. The average weekly dosage for estrogen HRT is 400mcg, which equates to four patches per week, two patches at a time for 3-4 days each. For those interested in starting with low-dose estrogen, the transdermal patches come in varying strengths.
For those ready to get started with FOLX for estrogen hormone replacement therapy, the process begins here. For existing FOLX members with questions about their dosage, don't hesitate to message or schedule time with a clinician. And for those who’ve just got some more questions, read up on estrogen here, and feel free to reach out to us at firstname.lastname@example.org.