The estradiol patch delivers bioidentical 17-beta estradiol through the skin at a steady rate. Because it bypasses first-pass hepatic metabolism, it avoids the clotting-factor increase that oral estrogen causes.
Why many guidelines prefer transdermal
- No increase in venous thromboembolism risk.
- No increase in stroke risk at standard doses.
- Neutral effect on triglycerides (oral estrogen can raise them).
- Safer option for women with migraine with aura, hypertension, or gallbladder disease.
Progesterone pairing
Patches are available in estrogen-only or combination (estrogen + progestin) formulations. Women with a uterus using an estrogen-only patch still need a separate progesterone — most commonly oral micronized progesterone at bedtime.
Common brand-name options
- Climara (weekly)
- Vivelle-Dot (twice weekly)
- Minivelle (twice weekly)
- CombiPatch (twice weekly, contains norethindrone)