Estradiol patch is a type of Hormone Replacement Therapy (HRT). Learn how to use the medication, side effects, special precautions, and more.

What is this medication for?

Estradiol patch is a type of Hormone Replacement Therapy (HRT). It contains a female hormone, estrogen. It is used to treat menopausal symptoms like hot flushes (feeling a sudden warmth of the face, neck and chest with the skin turning red), excessive sweating, vaginal dryness and bone loss. These symptoms are typically caused by a decrease in the levels of estrogen in the body, which happens naturally after menopause. Estradiol patch works by replacing the estrogen in the body.

Using estrogen alone may cause thickening of the uterus (womb) lining. For women who have an intact uterus, they will require an additional female hormone, progesterone, to prevent this. If your doctor prescribes progestogen for a specific duration (usually 10-14 days) each month, you will experience a withdrawal bleed (menses) after finishing the progestogen capsules/tablets.

How should I take/use this medication?

• Do not stop taking your medication without checking with your healthcare professional.
• The patch should be replaced two times a week (every 3 to 4 days). Change the patch on the same two days every week (e.g. Monday and Thursday). 

	Apply the patch to the lower abdomen, below the waistline. Do not put it on the waistline or places where it will be rubbed by tight clothing. Do not apply the patch to the breasts or any area near to the breasts, as well as on cuts or irritated skin.  Do not use creams, oils, powder, lotion or other skincare products on the application site. The patch may not stick well. Put the new patch on a different area of the skin each time. Do not apply a new patch to that same area of skin for at least one week.
	Do not use scissors to open the foil pouch.  Use your fingers to open the pouch by tearing it along the edge. Peel off one side of the protective backing and discard it.  Try not to touch the sticky surface.
	Put the patch on your skin. Take off the other half of the backing. Press down firmly on the patch with the palm of your hand for about 10 seconds. Make sure the patch sticks properly. Use your finger to run over the edges to ensure good contact between patch and skin.

• Normal activities (e.g. bathing, swimming, showering or exercising) should not affect how well the patch works. 
• If a patch falls off after these activities, shake it to remove the water. 
• Dry the skin then apply the same patch on a different area of the lower abdomen
• If the patch becomes loose, lifts at the edges or falls off, try to put it on again or put on a new patch immediately. 
• Do not use adhesives or wraps to keep the patch in place.

What should I do if I forget to take/use this medication?

If you forget to change a patch, change it as soon as you remember. Then apply your next patch on the same day as your original schedule. Do not apply two patches to make up for the missed patch.

What precautions should I take?

Inform your healthcare professional if: 

• You are allergic to this medication or any of the other ingredients of this medication.
• You are pregnant, planning to become pregnant, or breastfeeding.
• You are taking any other medications, including supplements, traditional medications and herbal remedies. 
• You have unexplained vaginal bleeding.
• You have a history of or current medical conditions such as liver problems, stroke, clotting disorders, heart diseases, migraine headaches, epilepsy (fits), diabetes or cancer.
• You are going for surgery or will be on bed rest. 
• You are going for a MRI scan. You may need to remove the patch during the scan.

What are some common side-effects of this medication?

• Breakthrough bleeding and spotting 
  • May occur during the first few months of treatment or if doses are missed. If it continues after the first months of treatment, appears after some time during therapy, or continues after treatment has been stopped, ask your doctor for advice. 
• Mood changes 
  • Use the medication at the same time every day to avoid huge changes in the hormone levels in your body, which can lead to mood changes.
• Breast tenderness (Breast swelling and pain)
• Headache
  • You may take Paracetamol to manage headaches.
• Nausea, vomiting, bloating and stomach cramps
  • You may consume smaller but more frequent meals, and avoid spicy, fatty food.
• Skin irritation at site of application
  • You may apply the patch on a different application site.

Consult your doctor about any symptom that becomes bothersome.

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following: 

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

Taking HRT increases a woman’s risk of developing blood clots and breast cancer. However, these are rare and the doctor would have evaluated and weighed its benefits over risks before making the recommendation. Please discuss with your doctor if you have any concerns.

The symptoms of blood clot include one or more of the following: 

• Any unusual sudden cough, breathlessness or difficulty in breathing
• Severe pain in the chest which may reach the left arm
• Severe pain in legs or swelling in either of your legs
• Weakness or numbness in any part of your body
• Change in your speech, including slurring of words
• Change in your senses of hearing, smell or taste
• Vision changes such as loss of vision/ blurred vision

It is also advisable to regularly check your breasts while you are on HRT. If you notice any unusual changes, please see your doctor immediately. 

Other rare but serious side effects that you may or may not experience include:

• Unexpected, heavy or longer than usual menstrual bleeding
• Dark urine or light coloured stools, nausea, vomiting, loss of appetite, stomach pain, yellowing of your eyes or skin
• Bothersome mood changes

If you experience any of these side effects/ symptoms, you should stop your medication and see your healthcare professional immediately.

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children. 

How should I throw away this medication safely?

Used patches may still contain some active hormones. Fold the used patch into half such that the adhesive sides stick together.

Pack this medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin.

Disclaimers

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last updated on April 2024.