Transdermal hormone patches may be safer than oral hormone therapy.
Hormone therapy is prescribed for troublesome symptoms during menopause. While very effective in treating symptoms such as hot flashes, night sweats and mood changes, its use has declined due to safety concerns. These safety concerns became very well publicized after the 2002 report from the Women’s Health Initiative study. Click here for more information.
Currently, the use of hormone therapy is still considered the gold standard for treating moderate to severe menopause symptoms. Due to safety concerns, use is generally limited to the lowest effective dose for the shortest time frame. However, women still have concerns about the potential risks associated with hormone therapy use. Fortunately, there is new research showing a potential benefit to alternative ways that hormone therapy is administered.
Hormone therapy is commonly administered in an oral tablet form. However, hormones can also be delivered effectively via the skin in a transdermal patch form. Due to the manner in which the hormone is metabolized once absorbed, practitioners have wondered if the patch is a safer way to deliver hormones. Click here for more information.
Good News for Women
Fortunately, two recent studies have found the transdermal patch to be a potentially safer way to administer menopause hormones. Most recently, Dr. Suissa and colleagues from McGill University in Montreal reported that the use of a low dose estrogen patch does not seem to increase the risk of stroke(1). In March, the same group reported that the patch was not associated with an increased risk of blood clots in postmenopausal women.
The most recent study used Britain’s national medical database to pick out 15,700 women over 50 who had strokes and nearly 60,000 who had not. The use of hormone therapy was divided by low and high dose products. High dose oral products were defined as containing more than 0.625 milligrams of equine estrogen or more than 2 milligrams of estradiol. High dose transdermal products were defined as containing greater than 50 micrograms estradiol per day.
The results showed that the risk of stroke was not increased with the use of low does patches compared to non-users, whereas the risk was increased with high dose patches. In addition, current users of both low and high dose oral hormone therapy had a higher rate of stroke than non-users. Hormone therapy tablets raised the risk of stroke by 25 – 30 percent, regardless of formulation. In contrast to the low dose transdermal patches showing no increase in stroke risk, the high dose patches increased the stroke risk by 88 percent.
Dr. Sunyecz, Medical Director and President of MenopauseRx comments: “While further study is needed, these results are very promising. The most commonly prescribed patch dose (50 micrograms per day or less) is considered a low dose patch by this study; therefore, no increase in stroke risk was identified. The use of hormone therapy for debilitating menopause symptoms will continue. Patients and their health care providers want the safest options when choosing a hormone therapy. If doctors had an option to prescribe hormone therapy that did not raise the risk of blood clots or stroke, patients would benefit greatly. I encourage all women suffering from debilitating menopause symptoms to arrange a conversation with their health care provider to discuss treatment options, including trandermal patches.”
Reference: (1): BMJ 2010;340:c2519