#Estradiol Transdermal System

[mcatmemoranda2]

Hormone Replacement Therapy for Menopause

My pt was started on a transdermal estrogen (Vivelle-Dot 0.025 mg twice a week) and an oral daily progestin. Then referred to me for f/u. I have no experience doing MHT. So I want to make sure it's done safely. My pt has low risk for ASCVD and the transdermal estrogen is safest in terms of risk of blood clots. So I think this is ok.

Menopausal hormone therapy (MHT) is a safe option for healthy, symptomatic women who are within 10 years of menopause or younger than age 60 years and who do not have contraindications to MHT (such as a history of breast cancer, coronary heart disease [CHD], a previous venous thromboembolic event or stroke, or active liver disease). Estrogen-progestin therapy should be used for women with a uterus and unopposed estrogen for those posthysterectomy. For women with vaginal atrophy symptoms only, we use low-dose vaginal estrogen.

MHT is effective for the treatment of menopausal hot flashes and vaginal atrophy caused by hypoestrogenism. Other symptoms associated with perimenopause and menopause that respond to estrogen include sleep disturbances, mood lability/depression, and, in some cases, joint aches and pains.

 Clinical practice guidelines (Endocrine Society, Menopause Society) suggest an individualized approach to treatment based upon calculating a woman's baseline cardiovascular and breast cancer risks prior to initiating therapy.

While the Women’s Health Initiative (WHI) demonstrated potential adverse effects of MHT in older postmenopausal women (over age 60 years), this is not the age group that presents with new onset of menopausal symptoms. Almost all women who seek medical therapy for menopausal symptoms do so in their late 40s or 50s.

When counseling women about MHT, the clinician should provide estimates for the absolute risks and benefits for up to five years of treatment in young postmenopausal women. Women should be reassured that the absolute risk of complications for healthy, young postmenopausal women taking MHT is very low.

Use of MHT decreased dramatically after the initial publication of the WHI in 2002. In spite of abundant evidence of its safety in younger menopausal women (from follow-up WHI analyses, metaanalyses, and additional clinical trials), prescription rates remain extremely low.

Menopausal hormone therapy (MHT) is the broad term used to describe both unopposed estrogen use for women who have undergone hysterectomy, and combined estrogen-progestin therapy (EPT) for women with an intact uterus who need a progestin to prevent estrogen-associated endometrial hyperplasia.

The primary goal of MHT is to relieve vasomotor symptoms (hot flashes). Other symptoms associated with perimenopause and menopause that respond to estrogen include sleep disturbances, depression/anxiety, and, in some cases, joint aches and pains.

Estrogen is also indicated for the management of genitourinary syndrome of menopause (GSM); however, low-dose vaginal estrogen should be used rather than systemic estrogen.

For healthy, peri/postmenopausal women with moderate to severe vasomotor symptoms impacting sleep, quality of life, or ability to function, and who are within 10 years of menopause (or <60 years of age), we suggest MHT.

We no longer use MHT for the prevention of chronic disease (osteoporosis, CHD, or dementia). However, there are some data to suggest that use of estrogen within the first 10 years after clinical menopause may reduce the risks of CHD and mortality.

All types and routes of estrogen are equally effective for hot flashes. We prefer 17-beta estradiol over other estrogens (such as conjugated equine estrogens [CEE]) because it is structurally identical (bioidentical) to the main estrogen secreted by the ovary. We suggest against the use of compounded bioidentical hormone therapy.

The transdermal route is particularly important in women with hypertriglyceridemia, active gallbladder disease, or known thrombophilias such as factor V Leiden (with or without a personal history of VTE). The baseline risk of both VTE and stroke is very low in otherwise healthy, young postmenopausal women. We therefore consider oral estradiol to be a safe and reasonable option for patients who prefer an oral preparation over a transdermal one (cost or personal preference).

For women with an intact uterus who are starting MHT and therefore require a progestin, we suggest micronized progesterone as our first-line progestin. It is effective for endometrial hyperplasia, is metabolically neutral, and does not appear to increase the risk of either breast cancer or CHD, although data are limited.

Standard recommendations for duration of use are three to five years. For women who experience recurrent, bothersome hot flashes after stopping estrogen, we initially try nonhormonal options. However, if this approach is unsuccessful and symptoms persist, we resume MHT at the lowest dose possible in carefully selected women with persistent, severe hot flashes. 

Women with primary ovarian insufficiency (POI) should continue MHT until the average of menopause, eg, age 50 to 51 years, to decrease the risk of premature CHD, stroke, osteoporosis, and dementia.

All types and routes of estrogen are equally effective for hot flashes, but transdermal preparations are associated with a lower risk of venous thromboembolism and stroke.

Endometrial hyperplasia and cancer can occur after as little as six months of unopposed estrogen therapy; as a result, a progestin should be added in women who have not had a hysterectomy. Women who have undergone hysterectomy should not receive a progestin.

For women unable to tolerate standard oral progestins, alternative approaches include a levonorgestrel-releasing intrauterine system (LNG-IUS; its use is off-label in the United States) or the combination conjugated estrogen-bazedoxifene regimen. 

That table is so hard to see. Here it is in pieces:

[truechemists]

A Comprehensive Guide to Buying Oestrogel and Rybelsus Online

Understanding Oestrogel and Its Uses

Oestrogel, a transdermal hormone replacement therapy (HRT), is widely prescribed to alleviate symptoms of menopause, such as hot flashes, mood swings, and osteoporosis. Its active ingredient, estradiol, mimics the natural estrogen in the body, helping women regain hormonal balance.

This gel formulation is applied directly to the skin, offering convenience and steady absorption. Unlike oral medications, Oestrogel bypasses the digestive system, reducing potential side effects while ensuring consistent hormone levels. This makes it an ideal choice for many women seeking a seamless way to manage menopausal symptoms.

The Role of Rybelsus in Diabetes Management

Rybelsus is an oral medication designed for adults with Type 2 diabetes. Its active ingredient, semaglutide, belongs to a class of drugs known as GLP-1 receptor agonists. This medication works by regulating blood sugar levels, promoting insulin secretion when blood sugar is high, and slowing digestion to prevent spikes.

Rybelsus offers significant benefits, including weight loss and reduced cardiovascular risks, making it a preferred option for patients aiming to manage their diabetes holistically. Unlike injectable alternatives, Rybelsus comes in tablet form, offering a more convenient treatment method.

Why Buy Oestrogel Online?

The convenience of purchasing Oestrogel online cannot be overstated. Online platforms provide discreet, hassle-free access to medications, eliminating the need for frequent trips to the pharmacy. Additionally, many online pharmacies offer detailed product descriptions, dosage guidelines, and patient reviews to help you make informed decisions.

When looking to buy Oestrogel online, ensure that the pharmacy is licensed and has positive customer feedback. A reputable source will also provide guidance on usage and potential side effects to ensure safe application.

Purchasing Rybelsus Online: What to Look For

For individuals managing diabetes, finding a reliable source to buy Rybelsus online is equally crucial. Online pharmacies often stock various dosages, allowing you to choose the one prescribed by your healthcare provider. Additionally, these platforms frequently offer competitive pricing and bulk purchase options, making ongoing treatment more affordable.

Before completing your purchase, verify the pharmacy’s credentials and check if they require a valid prescription. This ensures the legitimacy of the medication and safeguards your health.

Tips for a Safe Online Pharmacy Experience

While the advantages of online shopping are undeniable, caution is essential to ensure the safety and authenticity of your medications. Here are some tips for a secure experience:

Check Licensing: Always choose pharmacies that are licensed and regulated by relevant authorities.

Read Reviews: Look for customer reviews and testimonials to gauge the pharmacy’s reliability.

Verify Products: Ensure that the medications are FDA-approved and sourced from trusted manufacturers.

Seek Transparency: Reputable websites provide clear information about product ingredients, usage, and side effects.

Consult Your Doctor: Never purchase or start a new medication without consulting your healthcare provider.

Why Choose TrueChemists.com?

If you are looking for a trustworthy online pharmacy to purchase Oestrogel or Rybelsus, TrueChemists.com is an excellent option. With a commitment to quality and customer satisfaction, TrueChemists ensures that every product is genuine and delivered promptly. Their user-friendly platform, secure payment options, and detailed product descriptions make purchasing medications online a seamless experience.

Whether you need Oestrogel for hormonal balance or Rybelsus for diabetes management, TrueChemists.com has you covered. Visit their website today for a reliable and convenient solution to your pharmaceutical needs.

[your-god-empress-lavender]

Patches

I'M MAKING PATCHES! HAH! YEAH! Anyway, I'm a bit excited presently because not only have I found a way to make E patches at home that give 200µg/day (each), it's actually very easy to do and relatively cheap (and should give similar yields if testosterone is used). Okay, so, because I love starch so much, it (again) is starch based (please note however, while corn starch may work, it is relatively low amylopectin, so it will likely work worse than potato starch or tapioca, so keep this in mind when you attempt). While I'm still working on refining the recipe, here's the gist of what I've gotten to work so far:

Make a powder of starch and estrogen with 2/3 – 3/4 teaspoon of starch per milligram of estrogen. When calculating how much estrogen you put in, estimate how many days you expect to keep the patch on in the same place (I would do no more than 3), take that number and multiply by 200µg (0.2mg) and then again by the number of patches you intend to make from that batch, and finally add 0.2 milligrams extra. So, 2 patches that I want to last me 2 days would simply be 2•2•0.2 which ends up with 0.8 milligrams, plus 0.2 getting us up to 1 milligram. Since it's really hard to weigh out that low of an amount, I recommend mixing a measurable amount of estradiol with your starch in either this ratio or simply a ratio that allows for easy serial dilutions into the concentration we want.

Mix glycerol (glycerine) with water in a 50/50 ratio such that the final volume is roughly equal (or slightly above) the volume of the dry mix you are using.

Take the desired amount of dry mix and mix it thoroughly with the appropriate amount of wet mix. Spread this evenly onto a 3.5x3.5cm piece of cloth (can be cut out of an old piece of clothing), put the cloth piece on top of a piece of paper that is just slightly larger, then put it in the microwave (paper side down) to heat for 10 seconds. It should come out quite hot and very sticky.

Once it cools down enough to put on your skin, you can do that, and that's it. You now have 1 or more patches that should stick to your skin for up to 4 days (likely only 3). And aren't watertight, so unless you want to cover it in cellophane/plastic wrap, you probably can't wear it in a shower, so be sure to clean yourself in other ways or make it with less estradiol so each patch/batch of patches lasts you one day and put it on immediately after you shower.

FYI, the dosing information for transdermal E (patches) is such that the µg/day is roughly equal to the amount of circulating E there is in your system in pg/mL (the normal unit for measuring E levels in a person). And to add to the complexity, the amount passing through the skin changes depending on where it is. You get the best yields where skin is thin and soft (more often than not), but worse elsewhere. Good locations include: under the arm (anywhere from armpit to end of your ribs but on that under arm space), your rear, your abdomen, the under side of your knee (though a lot of movement may decrease how well it sticks). Bad locations include: upper thigh, arms, and your shins or below. Be safe and happy transing that gender!

[siglerprescriptiondrugcards]

Estradiol

Common Brand Names: See Below

Generic available in some formulations

Common Dosage Forms:

Topical Patients (Vivelle-Dot, Alora, Climara): Available to deliver 0.025 mg, 0.05 mg, 0.075 mg, and 0.1 mg each day

Tablets (Estrace): 0.5 mg, 1 mg, 2 mg

Divigel: 0.25 mg, 0.5 mg, 1 mg per packet

Femring Vaginal Insert: 5 mcg and 10 mcg delivered over 24 hours

Estring Vaginal Insert: 7.5 mcg delivered over 24 hours

Vagifem Suppository: 10 mcg

Cream (Estrace): 0.01%

*Not all forms are covered here, including injectable forms.

FDA Indications/Dosages:

Treatment of moderate to severe vasomotor symptoms associated with menopause, treatment of vulvar and vaginal atrophy, and treatment of hypoestrogenism due to hypogonadism, castration, or primary ovarian failure: Oral: 0.5-2 mg once daily. Vivelle-Dot, Alora: One patch applied twice weekly. Climara: One patch applied once weekly. Femring, Estring: Inserted vaginally once every 3 months. Vagifem, Estrace cream: Inserted vaginally from once daily to once weekly. Divigel: One packet applied daily.

Pharmacology/Pharmacokinetics: Estrogens promote growth and development of the vagina, uterus, and fallopian tube, and enlargement of the breasts. They are also involved in the process of menstruation. Estradiol is the more potent of the estrogens with estrone and estriol being less potent. In premenopausal women the ovarian follicle produces estradiol. In postmenopausal women the primary source of estrogen is through conversion of androstenedione to estrone. Transdermal applied estradiol avoids the first-pass metabolism of orally-administered estradiol to estrone. Estradiol has a half-life of 1 hour with reapplication estrogen levels being attained within 24 hours of removing a transdermal system.

Drug Interactions: Barbiturates, St. John’s Wort, carbamazepine, and rifampin may increase the metabolism of estrogens. Erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir, and grapefruit juice may decrease the metabolism of estrogens.

Contraindications/Precautions: Contraindicated in women with cancer of the breast, estrogen-dependant neoplasia, undiagnosed genital bleeding, active thromboembolic disorders or a past history of thromboembolic disorders, or during pregnancy. ESTROGEN-ALONE THERAPY INCREASES THE RISK OF STROKE, DEEP VEIN THROMBOSIS, ENDOMETRIAL CANCER, AND IN WOMEN OVER 65 YEARS OF AGE, PROBABLE DEMENTIA. Use with extreme caution in women with a family history of breast cancer or who have breast nodules, fibrocystic disease, or abnormal mammograms. Breast examinations should be performed periodically. Estrogens have been shown to increase the risk of gallbladder disease, thromboembolic disease, hepatic adenoma, high blood pressure, decreased glucose tolerance, and hypercalcemia. Use with caution in patients with a history of depression, when nursing, with liver, cardiac, or kidney dysfunction, and in those with epilepsy. Pregnancy Category X.

Adverse Effects: Irritation of application site, EDEMA, THROMBOEMBOLIC disorders, breast tenderness, disturbances in menstruation, and depression.

Patient Consultation:

Discuss the uses and dangers of estrogen therapy (package insert).

Do not take during pregnancy.

Closely follow cyclic administration.

Water will not affect patches.

Avoid application sites that are oily, damaged, irritated, or wet.

Store in a cool, dry place away from sunlight and children.

If a dose is missed, apply it as soon as possible. Do not double doses.

Contact a physician if the above side effects are severe or persistent.

[bhrttrainingacademy]

Think There is No Research To Support The Use of BHRT? Think Again!

I am sure you have read or heard someone say that there is no research to support the use of bioidentical hormones, often referred to as Bioidentical Hormone Replacement Therapy BHRT for short. One the other hand, proponents declare that there is plenty of supporting evidence.  Who is right? There certainly is a lot of conflicting information about bioidentical hormones and BHRT presented on the internet and thru the media.  There is no wonder health care providers as well as patients are confused. I will help sort it all out in this blog.

Why the Confusion About BHRT Research Anyway?

Before I dispel the misinformation regarding the so-called lack of research on BHRT I want to address why there is even an argument in the first place. I propose that the main reason many have come to the conclusion that there is no research to support the use of BHRT is that when they peruse the data looking for studies on BHRT there isn’t much to find. That is because of this word “bioidentical” – it is not yet a medically accepted word.  It is more of a marketing or slang word.  All the same, personally I think it is an accurate way to describe hormones that are biologically identical to human endogenously produced hormones. (For more details read my previous blog WHAT ARE BIOIDENTICAL HORMONES AND ARE THEY SAFE FOR YOUR PATIENTS) When searching through medical data, what you dofind are studies on estradiol, progesterone, and testosterone.  The hormones often used in studies arebioidentical hormones. However, they do not use the word “bioidentical”, just the name of the real hormone as in estradiol, for example.

BHRT Research

 Actually, there are decades of published studies that first started showing up as early as 1976.  In addition, there are recent popular studies including the Keeps Study, the Danish Study, WHI, The Pepi Trial, E3N, and the Danish Nurses Cohort Study that shed more light on this debate.

Here is a summary of what these studies demonstrated in regard to bioidentical hormones:

Bioidentical hormones have distinctly different effects.

Patients report greater satisfaction with HRT using progesterone vs progestin.

Progesterone is associated with a diminished risk for breast cancer compared to increased risk with progestins.

Progestins have a variety of negative cardiovascular effects including reduction of HDL, etc.

Estriol, estradiol, estrone and CEE have different physiological effects.

Transdermal estradiol is not associated with the same risk as oral estradiol.

Hysterectomized women treated with estradiol showed significant decrease inbreast cancer and mortality​.

Estradiol can be continued for at least 10 years without an increase in adverseevents and does not result in increased risk of breast cancer or stroke​.

Research Comparing Bioidentical Hormones to Non-Bioidentical

Even more compelling is research that compares the effects of bioidentical hormones to non-bioidentical hormones. Non-bioidentical hormones are hormones that have a different molecular structure than human hormones. These include Conjugated Equine Estrogen (CEE), Ethinyl Estradiol, or Medroxy Progestin Acetate for example. Here is the summary of what you need to know from the citations comparing non-bioidenticals to bioidenticals.​ I will share the references below for your review.

Bioidentical hormones convey more favorable or equally effective results than non-bioidentical hormones.

Bioidentical hormones are equally or more effective for these key symptoms sleep, mood, and vasomotor symptoms

Bioidentical hormones have been shown to improve lipid profiles, be safer, and lack side effects demonstrated with non-bioidenticals.

The risks associated with CEE and progestins in regard to breast cancer and cardiovascular events have not been reported with bioidentical hormones.

One of the most important things we have learned is that you cannot extrapolate the results from research done on one type of hormone and then apply it to a different type of hormone.  I recall the days when some uninformed medical professionals contended that all hormones are the same. That does not agree with what we know from basic chemistry – the molecular structure determines its properties.

Let it no longer be said there is no research on bioidentical hormones or they have not been shown to be safe.​  As you can see there isreputable data and furthermore bioidentical hormones have been demonstrated to be safer than their non-bioidentical counter parts.

I am convinced that patients prefer to work with open-minded, well-informed practitioners on this topic.  In fact, they are looking for you right now.  In addition to the fact that BHRT is evidenced based, not a fad compliance is very high.  Some clinicians estimate compliance is at least 90% or higher. As you know compliance on conventional HRT is very low.  Potential reasons for the poor compliance are assumed to be side effects or fear. In my 25+ years of experience in the field BHRT, women are seeking BHRT which makes them feel so much better.  Patients are well read now and want their providers to be resources they can trust to help manage their hormones.  With that in mind, in view of the growing body of research, as a provider you can confidently recommend and even begin to learn how to prescribe and implement BHRT into your practice.

Further Reading

Keeps Study

http://www.menopause.org/annual-meetings/2012-meeting/keeps-report

KEEPS study showed low dose estrogen and progesterone started within 5 years of menopause improved depression, anxiety, and cognitive function in healthy women without increased risk of CVD.

E3N

Int J Epidemiol. 2015 Jun;44(3):801-9. doi: 10.1093/ije/dyu184. Epub 2014 Sep 10.​

Data analyzed on 98,997 women concluding that progesterone regimens compared to synthetic progestin were associated with significantly lower breast cancer risks, and women that took HRT consistently were at lower risk of breast cancer than women who took HRT occasionally.

Fournier A, Berrino F, Clavel-Chapelon F. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study. Breast Cancer Res Treat. 2008; 107(1):103-111.

Another European 8 yearlong cohort study on postmenopausal women on transdermal estradiol and progesterone found no increased risk for breast cancer.

De Lignières B, de Vathaire F, Fournier S, et al. Combined hormone replacement therapy and risk of breast cancer in a French cohort study of 3175 women. Climacteric. 2002; 5:332-340.

Danish Nurses Cohort Study

Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomized trial.

BMJ 2012;345:e6409

Br J Cancer. 2005 Apr 11;92(7):1293-7​

Conducted on 19,898 women 45 years of age and older found the highest breast cancer risk to be in women who used continuous combined estrogen with synthetic progestin.

Stahlberg C, Pedersen A, Lynge E, et al. Increased risk of breast cancer following different regimens of hormone replacement therapy frequently used in Europe. Int J Cancer. 2004; 109:721-727.

Research published in JAMA found CEE and estradiol equally effective in relief of hot flashes but CEE has long-term risk of blood clot, stroke, and MI.

Nelson HD. Commonly used types of postmenopausal estrogen for treatment of hot flashes.

JAMA. 2004; 291(13):1610-1620.

PEPI Trial

Long term study on cardiovascular effects of both synthetic progestins and micronized progesterone with CEE. 

Writing group for the PEPI trial. Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women. The postmenopausal estrogen/progestin interventions (PEPI) trial.

JAMA. 1995; 273:199-208.

NON-BIOIDENTICAL VS BIOIDENTICAL HRT – COMPARATIVE STUDIES

Bioidentical hormones convey more favorable or equally effective results than non-bioidentical hormones.

1 Stanczyk FZ. All progestins are not created equal. Steroids. 2003; 68:879-890.

2 Place V, Powers M, Schenkel L, et al. A double-blind comparative study of estraderm and premarin in the amelioration of postmenopausal symptoms. Am J Obstet Gynecol. 1985; 152(8):1092-1099.

3 Writing group for the PEPI trial. Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women. The postmenopausal estrogen/progestin interventions (PEPI) trial. JAMA. 1995; 273:199-208.

 4 Good W, John V, Ramirez M, et al. Double-masked, multicenter study of an estradiol matrix transdermal delivery system (Alora™) versus placebo in postmenopausal women experiencing menopausal symptoms. Clin Ther. 1996; 18:1093-1105.

5 Stahlberg C, Pedersen A, Lynge E, et al. Increased risk of breast cancer following different regimens of hormone replacement therapy frequently used in Europe. Int J Cancer. 2004; 109:721-727.

6 Nelson HD. Commonly used types of postmenopausal estrogen for treatment of hot flashes.

JAMA. 2004; 291(13): 1610-1620.

7 Fournier A, Berrino F, Clavel-Chapelon F. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study. Breast Cancer Res Treat. 2008; 107(1): 103-111.

8 De Lignières B, de Vathaire F, Fournier S, et al. Combined hormone replacement therapy and risk of breast cancer in a French cohort study of 3175 women. Climacteric. 2002; 5:332-340.

Bioidentical HRT Effective for Symptoms (Sleep, Mood and Vasomotor), Safer, Lack of Side Effects, No Risk of Breast Cancer, Improved Lipid Profiles.

1 Stahlberg C, Pedersen A, Lynge E, et al. Increased risk of breast cancer following different regimens of hormone replacement therapy frequently used in Europe. Int J Cancer. 2004; 109:721-727.

2 Fournier A, Berrino F, Clavel-Chapelon F. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study. Breast Cancer Res Treat. 2008; 107(1): 103-111.

3 De Lignières B, de Vathaire F, Fournier S, et al. Combined hormone replacement therapy and risk of breast cancer in a French cohort study of 3175 women. Climacteric. 2002; 5: 332-340.

4 Grady D, Vittinghoff E, Lin F, et al. Effect of ultra-low-dose transdermal estradiol on breast density in postmenopausal women.Menopause J North Am Men Soc. 2007; 14(3):1-6.

5 Simon JA, Bouchard C, Waldbaum A, et al. Low dose of transdermal estradiol (E2) gel for treatment of symptomatic postmenopausal women. Obstet Gynecol. 2007; 109(2):1-10.

6 Montplaisir J, Lorrain J, Denesle R, et al. Sleep in menopause: differential effects of two forms of hormone replacement therapy. Menopause. 2001;8(1): 10-16.

7 Gambacciani M, Ciaponi M, Cappagli B, et al. Effects of low-dose, continuous combined hormone replacement therapy on sleep in symptomatic postmenopausal women. Maturitas. 2005; 50:91-97.

8 Zegura B, Guzic-Salobir B, Sebestjen M, et al. The effect of various menopausal hormone therapies on markers of inflammation, coagulation, fibrinolysis, lipids, and lipoproteins in healthy postmenopausal women. Menopause. 2006; 13(4):643-650.

The risks associated with CEE and progestins in regard to breast cancer, cardiovascular events have not been reported with bioidentical hormones.

1 Stanczyk FZ. All progestins are not created equal. Steroids. 2003; 68:879-890.

2 Fournier A, Berrino F, Clavel-Chapelon F. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study. Breast Cancer Res Treat. 2008; 107(1):103-111.

3 De Lignières B, de Vathaire F, Fournier S, et al. Combined hormone replacement therapy and risk of breast cancer in a French cohort study of 3175 women. Climacteric. 2002; 5:332-340.

4 Santen RJ. Risk of breast cancer with progestins: critical assessment of current data.

Steroids. 2003; 68:953-964.

5 Schairer C, Lubin J, Troisi R, et al. Menopausal estrogen and estrogen-progestin replacement therapy and

breast cancer risk. JAMA. 2000; 283:485-491.

6 Schindler A. European Progestin Club. Differential effects of progestins. Maturitas. 2003; 46: S3-S5.

7 Grady D, Vittinghoff E, Lin F, et al. Effect of ultra-low-dose transdermal estradiol on breast density in postmenopausal women.Menopause J North Am Men Soc. 2007; 14(3):1-6.

8 Simon JA, Bouchard C, Waldbaum A, et al. Low dose of transdermal estradiol (E2) gel for treatment of symptomatic postmenopausal women. Obstet Gynecol. 2007; 109(2):1-10.

9 Montplaisir J, Lorrain J, Denesle R, et al. Sleep in menopause: differential effects of two forms of hormone replacement therapy. Menopause. 2001; 8(1): 10-16.

10 Gambacciani M, Ciaponi M, Cappagli B, et al. Effects of low-dose, continuous combined hormone replacement therapy on sleep in symptomatic postmenopausal women. Maturitas. 2005; 50:91-97.

11 Zegura B, Guzic-Salobir B, Sebestjen M, et al. The effect of various menopausal hormone therapies on markers of inflammation, coagulation, fibrinolysis, lipids, and lipoproteins in healthy postmenopausal women. Menopause. 2006; 13(4):643-650.

12 Rossow J, Anderson G, Prentice R, et al. Writing Group for the Women’s Health Initiative. Risks and benefits of estrogen plus progestin in healthy postmenopausal women. JAMA. 2002; 288(3):321-333.

13 Wassertheil-Smoller S, Hendrix S, Limacher M, et al. Effects of estrogen plus progestin on stroke in postmenopausal women. The women’s health initiative: a randomized trial. JAMA. 2003; 289(20):2673-2684

14 Porch J, Lee I, Cook N, et al. Estrogen-progestin replacement therapy and breast cancer risk: the women’s health study (United States). Cancer Causes Control. 2002; 13:847-854.

15 Statement on the estrogen plus progestin trial of the Women’s Health Initiative. ACOG News release. 2002.

[pharmacyforthemasses]

I have had a full hysterectomy and ovary removal. I use an estradiol patch changed twice a week. It’s Medicare open enrollment and I’m comparing plans. Most don’t cover my patch. It’s over $700. Is there a cheaper form of estrogen that I could switch to? Why are these patches so expensive? They are generic! Is oral estrogen comparable? I googled and saw some coupons for estradiol- are coupons used once only or can I use them every month?? Thankyou for your time!

Hi there!

Estrogen therapy is available as a skin patch, a cream/gel, a vaginal ring, and a pill. Different formulations have different risks and benefits. Transdermal estrogen (the patch, cream/gel) has the lowest risk of causing blood clots, so that makes it a good choice for a lot of women. Oral estrogen has a higher risk of causing blood clots because it passes through the liver before being circulated systemically, and that affects blood coagulation (I’ll spare you the details).

So, yes, there are other forms of estrogen available but I can’t say if they would be a better fit for you. It’s a risk/benefit discussion you’d have to have with your doctor.

I’m not sure why it’s so expensive, and it’s bullshit that most Medicare plans won’t cover it. Can you get a prior authorization and get it covered that way?

As for coupons, my pharmacy allowed people to print out multiple copies of the same online coupon and use them every month. Most pharmacists aren’t going to hassle you about that, we hate the pharmaceutical companies as much as patients do, and coupons make manufacturers eat the cost.

[cherylrhutcherson]

Global Estradiol Transdermal System Market - Overview and Regional Outlook Study 2019-2025

Estradiol is in a class of medications called estrogen hormones. It works by replacing estrogen that is normally produced by the body. Most brands of estradiol transdermal patches are used to treat hot flushes (hot flashes; sudden strong feelings of heat and sweating) and/or vaginal dryness, itching, and burning in women who are experiencing menopause (change of life; the end of monthly menstrual periods). Transdermal estradiol is also used to prevent osteoporosis (a condition in which the bones become thin and weak and break easily) in women who are experiencing or have experienced menopause.

Request a Sample Copy of this Report@ https://www.orbisresearch.com/contacts/request-sample/2374846

In 2017, the global Estradiol Transdermal System market size was xx million US$ and is forecast to xx million US in 2025, growing at a CAGR of xx% from 2018. The objectives of this study are to define, segment, and project the size of the Estradiol Transdermal System market based on company, product type, application and key regions.

This report studies the global market size of Estradiol Transdermal System in key regions like North America, Europe, Asia Pacific, Central & South America and Middle East & Africa, focuses on the consumption of Estradiol Transdermal System in these regions.

This research report categorizes the global Estradiol Transdermal System market by players/brands, region, type and application. This report also studies the global market status, competition landscape, market share, growth rate, future trends, market drivers, opportunities and challenges, sales channels, distributors and Porter’s Five Forces Analysis.

The various contributors involved in the value chain of Estradiol Transdermal System include manufacturers, suppliers, distributors, intermediaries, and customers.

The key manufacturers in the Estradiol Transdermal System include

Novartis

Allergan

Bayer

Noven Therapeutics

Mylan

Vertical Pharmaceuticals

Perrigo Pharma International

Market Size Split by Type

0.025 mg per day

0.0375 mg per day

0.05 mg per day

0.075 mg per day

0.1 mg per day

Market Size Split by Application

Hot flashes

Prevention of postmenopausal osteoporosis

Treatment of hypoestrogenism

Moderate-to-severe vasomotor symptoms

Others

Market size split by Region

North America

United States

Canada

Mexico

Asia-Pacific

China

India

Japan

South Korea

Australia

Indonesia

Singapore

Malaysia

Philippines

Thailand

Vietnam

Europe

Germany

France

UK

Italy

Spain

Russia

Central & South America

Brazil

Rest of Central & South America

Middle East & Africa

GCC Countries

Turkey

Egypt

South Africa

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Some Point from Table of Content:

Chapter One: Study Coverage

1.1 Estradiol Transdermal System Product

1.2 Key Market Segments

1.3 Key Manufacturers Covered

1.4 Market by Type

1.4.1 Global Estradiol Transdermal System Market Size Growth Rate by Type

1.4.2 0.025 mg per day

1.4.3 0.037Chapter Five: mg per day

1.4.4 0.0Chapter Five: mg per day

1.4.5 0.07Chapter Five: mg per day

1.4.6 0.1 mg per day

1.5 Market by Application

1.5.1 Global Estradiol Transdermal System Market Size Growth Rate by Application

1.5.2 Hot flashes

1.5.3 Prevention of postmenopausal osteoporosis

1.5.4 Treatment of hypoestrogenism

1.5.5 Moderate-to-severe vasomotor symptoms

1.5.6 Others

1.6 Study Objectives

1.7 Years Considered

Chapter Two: Executive Summary

2.1 Global Estradiol Transdermal System Market Size

2.1.1 Global Estradiol Transdermal System Revenue 2016-2025

2.1.2 Global Estradiol Transdermal System Sales 2016-2025

2.2 Estradiol Transdermal System Growth Rate by Regions

2.2.1 Global Estradiol Transdermal System Sales by Regions

2.2.2 Global Estradiol Transdermal System Revenue by Regions

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Transdermal Skin Patches Market will generate new growth opportunities 2023-2028

Transdermal patches are a method of drug delivery in which an adhesive patch provides a pre-prescribed dose of medication that is absorbed through the skin and into the bloodstream. The term ‘transdermal’ describes a delivery method used for administering pharmaceuticals. These patches are designed for short-term or long-term administration and can either be electronic or mechanical. Transdermal patches adhere to the skin as a way to deliver drugs. They provide a specific, predetermined dose of medicine which is absorbed through the skin and into the blood. Although comparable to oral-dosage forms in efficacy, skin patches have several advantages over oral forms. They provide a non-invasive and painless method of drug delivery.

Market Statistics:

The global transdermal skin patches market was valued at US$ 7,695.0 Mn in 2021 and is forecast to reach a value of US$ 10,839.7 Mn by 2028 at a CAGR of 5.0% between 2022 and 2028.

Market Drivers:

1.      Growing adoption of transdermal skin patches is expected to boost the growth of the global transdermal skin patches market during the forecast period. For instance, in December 2020, Agile Therapeutics, Inc. announced the U.S. commercial launch of Twirla (levonorgestrel and ethinyl estradiol) transdermal system, a new non-daily, non-invasive contraceptive patch. It is now available in the U.S. by prescription for women of reproductive potential with a BMI 30 kg/m2. It is designed to be worn on the abdomen, buttock, or upper torso (excluding breasts).

2.      Growing funding and investments for drug development is expected to propel the growth of the global transdermal skin patches market over the forecast period. For instance, in May 2019, Mercia invested £2.0 million in transdermal drug delivery specialist Medherant Limited. This latest investment will enable Medherant to finalize the selection of three TEPI Patch products to take into clinical development. The development of patch products that will bring significant benefits to patients across the globe.

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New Step By Step Map For fertility medication

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Unlocking Health and Wellness: A Guide to Hormonal Treatments

Understanding HMG Injection

Human Menopausal Gonadotropin (HMG) injection is widely used in fertility treatments. This medication is a combination of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), both essential for ovulation and sperm production. It’s a common choice for women undergoing in-vitro fertilization (IVF) or other assisted reproductive technologies (ART).

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Oestrogel: A Trusted Solution for Hormonal Imbalances

Oestrogel, a transdermal gel containing estradiol, is an innovative solution for managing estrogen deficiencies. It is frequently prescribed for women experiencing menopause symptoms such as hot flashes, night sweats, and mood swings. Additionally, it can help prevent osteoporosis, a condition that weakens bones due to decreased estrogen levels.

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Global Topical Drug Delivery Market Business Analysis, Future Trend & Global Research Report

Global Topical Drug Delivery Market

Topical drug delivery is defined as the delivery of drugs through topical route like skin, mucus membrane or cavities in the body. These are applied topically the body. These drugs are applied locally to avoid the first-pass effect of the drug or for site-specific action. These medications include foams, lotions, creams, gels, ointments, and others. Topical drug delivery has various benefits such as site-specificity, better compliance, eliminating fluctuations in the levels of drugs, and improved suitability for self-medication.

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Regional Analysis

The Global Topical Drug Delivery Market is segmented into five regions such as North America, Latin America, Europe, Asia Pacific, and Middle East & Africa.

The Asia Pacific region is expected to grow at the highest CAGR during the forecast period. This is due to the increase of skin diseases like skin cancer, the growing use of contraceptives, and the increase in focus of pharmaceutical companies on the research and development of smart transdermal drug delivery systems, all of which are propelling adoption of topical drug delivery in the region. Also, the North America dominates the market due to the presence of large number of pharmaceutical companies & drug delivery technology providers in the region.

Key Players

Some key operating players are listed in this report such as Bausch Health Companies, Agile Therapeutics, Hisamitsu Pharmaceutical, Cipla, Almirall U.S., Cassiopea, Crescita Therapeutics Inc., 3M, MERCK & CO., Bayer AG, etc. Merger acquisition, partnership, and product launch are some key strategies adopted by the key players & sustain and capture the market share in the global topical drug delivery market. For instance, in December 2020, Agile Therapeutics, Inc. had launched its new Twirla (levonorgestrel and ethinyl estradiol) transdermal system which is a contraceptive patch.

Market Taxonomy

By Product type

·       Formulations

Semisolid

Creams

Gels

Pastes

Ointments

Lotions

 Liquid

Solutions

Suspensions

Solid

Suppositories

Powders

Devices

Transdermal     Patches

Transdermal     Gels

By Route of Administration

Skin

Ophthalmic

Rectal

Vaginal

 Nasal

 By End User

Home Care Settings

 Hospitals & Private Clinics

 Others

Get Details of Global Topical Drug Delivery Market @ https://qualiketresearch.com/reports-details/Topical-Drug-Delivery-Market

About Us 

QualiKet Research is a leading Market Research and Competitive Intelligence partner helping leaders across the world to develop robust strategy and stay ahead for evolution by providing actionable insights about ever changing market scenario, competition and customers. QualiKet Research is dedicated to enhancing the ability of faster decision making by providing timely and scalable intelligence. We use different intelligence tools to come up with evidence that showcases the threats and opportunities which helps our clients outperform their competition.

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Estradiol Transdermal System Market 2021 Overview, Key Players, Segmentation Analysis, Development Status And Forecast By 2031

Estradiol Transdermal System Market 2021 Overview, Key Players, Segmentation Analysis, Development Status And Forecast By 2031

Global Latest Report Estradiol Transdermal System Market: with growing significant CAGR during Forecast 2021-2031(Based on COVID-19 Worldwide Spread) Global Estradiol Transdermal System Market Report offers an entire study of the Impact of COVID-19 on Estradiol Transdermal System Market, Industry Outlook, Opportunities in Market, and Expansion By 2031 and also taking into consideration key…

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Topical Drug Delivery Market Top 5 Competitors, Regional Trend, Application, Marketing Strategy, Outlook Analysis and Forecast

Global Topical Drug Delivery Market

Topical drug delivery is defined as the delivery of drugs through topical route like skin, mucus membrane or cavities in the body. These are applied topically the body. These drugs are applied locally to avoid the first-pass effect of the drug or for site-specific action. These medications include foams, lotions, creams, gels, ointments, and others. Topical drug delivery has various benefits such as site-specificity, better compliance, eliminating fluctuations in the levels of drugs, and improved suitability for self-medication.

Market Drivers

The increase in approval of new drugs from U.S. FDA is expected to drive growth of the global topical drug delivery market. For instance, in August 2020, the U.S. Food and Drug Administration (FDA) announced the approval of Cassiopea’s Winlevi drug, which is used for the treatment of topical acne treatment from. Furthermore, the increase in prevalence of skin diseases and high incidence of burn injuries, expected to boost the global topical drug delivery market growth over the forecast period. For instance, Information provided by the World Health Organization (WHO), around 2 to 3 million cases of non-melanoma skin cancer and around 132,000 cases of melanoma skin cancer are diagnosed every year across the globe.

Get Sample Copy of this Report @ https://qualiketresearch.com/request-sample/Topical-Drug-Delivery-Market/request-sample

Moreover, new product launches are expected to boost the global topical drug delivery market. For instance, in February 2021, Almirall U.S., biopharmaceutical company focused on skin health, launched new drug (Klisyri). It is used as the topical treatment for actinic keratosis (AK) of the face and scalp. Actinic keratosis (AK) is the most common diagnosis made by dermatologists in the United States, affects more than 40 million Americans annually. In addition, the increase in geriatric population will positively influence the global topical drug delivery market growth throughout the forecast period.

Market Restraints

Availability of alternative dug delivery modes for patients and end users expected to hamper the global topical drug delivery market growth. Also, side effects of topical drugs like allergies and rashes, and slow onset of action hinder the growth of global topical drug delivery market growth.

Market Segmentation

On the basis of product type global topical drug delivery system market is segmented into Formulations, and devices. Further, formulations are sub segmented into Semisolid (Creams, Gels, Pastes, Ointments, and Lotions), Liquid (Solutions, Suspensions), and Solid (Suppositories, and Powders). Also, the Devices are classified into Transdermal Patches, and Transdermal Gels.

Based on the product type semisolid is expected to witness the highest growth throughout the forecast period. Due to the advantages of dermal drug delivery over other topical drug delivery methods, such as convenience and greater patient compliance.

Based on the route of administration market is segmented into Skin, Ophthalmic, Rectal, Vaginal, and Nasal. In addition, the market is segmented into end user such as Home Care Settings, Hospitals & Private Clinics, and Others. The home care settings segment holds largest share of the market during this forecast period, owing to factors such as the convenience & affordability of topical drugs for home administration.

Regional Analysis

The Global Topical Drug Delivery Market is segmented into five regions such as North America, Latin America, Europe, Asia Pacific, and Middle East & Africa.

The Asia Pacific region is expected to grow at the highest CAGR during the forecast period. This is due to the increase of skin diseases like skin cancer, the growing use of contraceptives, and the increase in focus of pharmaceutical companies on the research and development of smart transdermal drug delivery systems, all of which are propelling adoption of topical drug delivery in the region. Also, the North America dominates the market due to the presence of large number of pharmaceutical companies & drug delivery technology providers in the region.

Key Players

Some key operating players are listed in this report such as Bausch Health Companies, Agile Therapeutics, Hisamitsu Pharmaceutical, Cipla, Almirall U.S., Cassiopea, Crescita Therapeutics Inc., 3M, MERCK & CO., Bayer AG, etc. Merger acquisition, partnership, and product launch are some key strategies adopted by the key players & sustain and capture the market share in the global topical drug delivery market. For instance, in December 2020, Agile Therapeutics, Inc. had launched its new Twirla (levonorgestrel and ethinyl estradiol) transdermal system which is a contraceptive patch.

Market Taxonomy

By Product type

Formulations

Semisolid

Creams

Gels

Pastes

Ointments

Lotions

Liquid

Solutions

Suspensions

Solid

Suppositories

Powders

Devices

Transdermal Patches

Transdermal Gels

By Route of Administration

Skin

Ophthalmic

Rectal

Vaginal

Nasal

By End User

Home Care Settings

Hospitals & Private Clinics

Others

Browse Full Research Report @ https://qualiketresearch.com/reports-details/Topical-Drug-Delivery-Market

About Us

QualiKet Research is a leading Market Research and Competitive Intelligence partner helping leaders across the world to develop robust strategy and stay ahead for evolution by providing actionable insights about ever changing market scenario, competition and customers. QualiKet Research is dedicated to enhancing the ability of faster decision making by providing timely and scalable intelligence. We use different intelligence tools to come up with evidence that showcases the threats and opportunities which helps our clients outperform their competition.