Estalis is a patch containing oestrogen and a similar hormone to progesterone (these are called ‘progestogens’). The oestrogen is exactly the same as your own body makes (body-identical) and the progestogen is norethisterone acetate, similar but not identical to your own hormones. It is released slowly, straight into the blood stream. This way you can avoid some of the side effects of oestrogen tablets which first pass through your liver. There is currently no body identical progesterone available in a combined patch.
Estalis can be used during perimenopause and after menopause to replace your body’s falling oestrogen and progesterone levels. It is an excellent treatment for many of the symptoms of menopause caused by low oestrogen eg flushes, vaginal dryness, bladder problems, sleep problems, irritability and depression. Estalis also helps to prevent osteoporosis, diabetes, depression and may even prevent cardiac disease and dementia. The combination with progestogen is a convenient way to protect your endometrial lining if you have a uterus.
Perimenopause – Estalis sequi (progestogen only in patches during the second half of the cycle) giving you a monthly bleed.
Postmenopause – Estalis conti (progestogen in every patch) so there should be no bleeding.
How to use Estalis
Estalis is a patch that you apply to clean, dry skin on your bottom, thighs or lower tummy. It sticks well but keep it away from waistbands which might rub against it. Use a different area of skin area of skin each time to avoid irritation. You have the patch on 24/7. If the patch is not sticking well, try cleaning your skin with a little nail polish remover first.
You re-apply your patch twice a week. It is a good idea to make it a regular time such as Sunday evening (right butt cheek) and Thursday morning (left butt cheek), whatever days of the week suit you best. You could send yourself a calendar reminder or write these times on your prescription box to bypass any brain fog. Your doctor may ask you to use Estalis differently depending on your symptoms eg use additional oestrogen (another patch, gel or vaginally) each day or on some days.
Estalis comes in 2 different strengths which have different amounts of progestogen but the same oestrogen. It is common to have to adjust your patch according to your response. It takes a few months to settle into your right dose and you may also need to change doses as you journey through menopause. Vaginal bleeding in particular is common in the first few months.
Risks of using HRT
Thrombosis
The risk of blood clots is NOT increased with Estalis.
A thrombosis is the formation of a blood clot which may block a blood vessel.
A thrombosis sometimes occurs in the deep veins of the legs (deep venous thrombosis). If this blood clot breaks away from the veins where it is formed, it may reach and block the arteries of the lungs, causing a so-called “pulmonary embolism”. Deep venous thrombosis is a rare occurrence. It can develop whether or not you are taking oestrogen. The risk is higher in oestrogen-users than in non-users. The increased risk has been seen with tablet or oral oestrogen use and not when used through the skin.
Breast cancer
Some females using HRT will be diagnosed with breast cancer slightly more often than those not using HRT. The studies showing this were using non-body-identical HRT in certain groups of females and the risk is very small. There is no increased risk of dying from breast cancer nor any increased risk of dying from any cause (all cause mortality).
It is not clear whether this is caused by the HRT. It may be that the women were examined more often because they were on HRT, or that early cancers grew more quickly.
Studies show that about one extra case of breast cancer in 1000 women is diagnosed when women use combined HRT – oestrogen AND progestogen (non-body-identical formulations of progesterone). Studies show that women using oestrogen alone (without progesterone) have lower rates of breast cancer diagnosis – also about one less diagnosis in 1000 women.
Please talk to your doctor about how these risks weigh up against the benefits for you personally.
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Reasons not to start Estalis
Allergies to Estrogel
Unexplained vaginal bleeding
Severe liver disease
You are pregnant or breast feeding
Speak with your doctor about any risks because you have…
Blood clots
Stroke
Heart attack
Cancer
Migraines
Postnatal depression
Severe mood disorder
Side effects of Estalis
Side effects are uncommon and you may not experience any. Most are not serious and will settle over a few months.
Nausea, headache, breakthrough vaginal bleeding or spotting, bloating, period like discomfort, acne, breast pain or tenderness, changes in mood, libido or sleep, constipation, irritation of the patch adhesive.
Stop taking Estalis and seek medical advice if…
Migraines are getting worse
The skin or eyes are becoming yellow
Pain in your calves or chest, sudden shortness of breath indicating possible clots*
Severe headache, vomiting, dizziness, changes in vision, speech, numbness, weakness of an arm or leg*
* go to emergency as these need immediate assessment.
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