Hormones And The Brain
That’s not to say estrogen isn’t a major player in regulating moods. Estrogen acts everywhere in the body, including the parts of the brain that control emotion.
Some of estrogen’s effects include:
- Increasing serotonin, and the number of serotonin receptors in the brain.
- Modifying the production and the effects of endorphins, the “feel-good” chemicals in the brain.
- Protecting nerves from damage, and possibly stimulating nerve growth.
What these effects mean in an individual woman is impossible to predict. Estrogen’s actions are too complex for researchers to understand fully. As an example, despite estrogen’s apparently positive effects on the brain, many women’s moods improve after menopause, when estrogen levels are very low.
Some experts believe that some women are more vulnerable to the menstrual cycle’s normal changes in estrogen. They suggest it’s the roller coaster of hormones during the reproductive years that create mood disturbances.
Prevention Of Postmenopausal Osteoporosis
Estradiol transdermal system is indicated for the prevention of postmenopausal osteoporosis.
Limitation of Use
When prescribing solely for the prevention of postmenopausal osteoporosis, therapy should only be considered for women at significant risk of osteoporosis and non-estrogen medications should be carefully considered.
Estradot 50 Micrograms/24 Hours Transdermal Patch
This information is intended for use by health professionals
Estradot® 50 micrograms/24 hours, transdermal patch.
5 cm2 patch containing 0.78 mg estradiol with a release rate of 50 micrograms estradiol per 24 hours.
For the full list of excipients, see section 6.1.
Transdermal patch.
Rectangular patch with rounded corners, comprising a pressure-sensitive adhesive layer containing estradiol, with a translucent polymeric backing on one side and a protective liner on the other.
Hormone replacement therapy for oestrogen deficiency symptoms in postmenopausal women.
Prevention of osteoporosis in postmenopausal women at high risk of future fractures who are intolerant of, or contraindicated for, other medicinal products approved for the prevention of osteoporosis .
The experience treating women older than 65 years is limited.
Dosage
The transdermal patch is applied twice weekly, i.e. every three to four days.
Oestrogen deficiency symptoms:
Estradot is available in five strengths: 25, 37.5, 50, 75 and 100. For initiation and continuation of treatment of postmenopausal symptoms, the lowest effective dose for the shortest duration should be used. Depending on the clinical response the dose can then be adjusted to the patient’s individual needs. If, after three months, there is insufficient response in the form of alleviated symptoms, the dose can be increased. If symptoms of overdose arise the dose must be decreased.
Prevention of postmenopausal osteoporosis:
General instructions
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Estrogen And Postpartum Depression
Having “the blues” after childbirth is so common it’s considered normal. However, 10% to 25% of women experience a major depression within the first six months after childbirth. The abrupt drop in estrogen after delivery seems like the obvious culprit — but this link has never been proved.
Postpartum depression is treated like any other depression, with antidepressants, therapy, or both. Some preparations of estrogen do show promise as a potential add-on to these established treatments.
How Often Do You Need To Get Your Hormone Replacement Therapy
The frequency of use may be a significant driving factor for some people. You need to take the pills every day, knowing if you miss one, you may be facing mood swings and an increased risk of various side effects, and will also make the first pass through the liver. If you are disciplined, this may not be an issue. But, you have to take into consideration your habits.
People who are seeking a more natural application can use creams and gels. These need to be used several times per day without fail. It is the most cost-effective method, but the most labor-intensive. Absorption rates may vary greatly from patient to patient and also within the same patient.
Injections need to be done one to three times per week, requiring you to have a doctors visit for each injection or do the injection from yourself. Each time you visit the doctors office, you have to take time off from work, have transportation, and possibly face additional charges that include co-pays for the office visit. Injectables are often associated with uneven absorption and a roller coaster effect of hormone delivery, resulting in high peaks and low valleys.
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Treatment Of Moderate To Severe Vasomotor Symptoms
Start therapy with estradiol transdermal system 0.0375 mg per day applied to the skin twice weekly. Dosage adjustment should be guided by the clinical response.
Therapy should be started at the lowest effective dose and the shortest duration consistent with the treatment goals. Attempts to taper or discontinue the medication should be made at 3 to 6 month intervals.
Troubleshooting : Estrogen Patches
Estrogen Patches
One form of HRT that is both popular and available to women in Surgical Menopause to treat their menopausal symptoms are estrogen patches . Estrogen patches are a transdermal form of delivering 17-beta Estradiol, meaning that the medication is absorbed and delivered through the skins membrane. Estrogen patches are designed to slowly and steadily release Estradiol into a womans body over several days, and are applied twice weekly or weekly depending on the brand of estrogen patches you are using.
The advantages of using Estrogen Patches over other forms of HRT are several.
Lower risk:;The advantage of receiving your HRT via skin delivery is that unlike oral HRT which carries with it a higher risk of stroke, blood clots, and heart attack, estrogen patches bypass the liver and go;directly into the bloodstream; thus putting women at a lower risk of these scenarios including those with a prior history of blood clot risk. A research study that was conducted in 2007 revealed that the estrogen patch does not present the risk of blood clots in postmenopausal women the same way oral estrogen does.
Fewer Fluctuations: A common issue women have with feeling well on HRT is that they experience hormone fluctuations in the periods;between their HRT doses. However because estrogen patches are designed to be a slow release form of HRT, they provide a steady dose of hormones over several days meaning that fluctuations are minimized.
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What Is Estradiol Patch
Estradiol is a form of estrogen, a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.
Estradiol Patches are used to treat certain symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Estradiol Patch is also used to prevent postmenopausal osteoporosis, or to treat ovarian disorders.
Estradiol Patch may also be used for purposes not listed in this medication guide.
What Should I Avoid While Using Estradiol Patch
Avoid smoking. It can greatly increase your risk of blood clots, stroke, or heart attack while using estradiol.
Grapefruit may interact with estradiol and lead to unwanted side effects. Avoid the use of grapefruit products.
Avoid using creams, lotions, or powders on the skin where you apply the patch, or it may not stick to your skin.
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Vaginal Suppositories Rings And Creams
Vaginal Suppositories, Rings, and Creams are another form of estrogen replacement therapy, and these can be directly applied to the vaginal area. These come in tablet forms like Imvexxy, Vagifem, creams like Estrace or Estradiol, and insertable rings like Estring or Femring. These are generally opted for by women that are troubled with vaginal dryness, painful sex, itchiness.
These Vaginal tablets are used daily for a couple of weeks; after that, they can be used twice a week. Creams can be used daily, several times a week. Vaginal rings need to be changed every three weeks.
Pros
Just like the patches, some of these treatments are more convenient than taking a pill every day. Some vaginal rings and suppositories have low doses of estrogen. As a result, it affects just the particular area where it is applied. Hence they dont expose the whole body to estrogen unnecessarily. These treatments are more effective in treating vaginal dryness in a better way than other forms of estrogen replacement therapy.
Cons
Since vaginal suppositories and rings have low doses of estrogen, they do not treat other symptoms of menopause like hot flashes other than vaginal dryness. There are some higher dosed ones available, but then again they raise the risk of cancer and stroke. Women that still have their uterus intact or in other words havent had hysterectomy long term use of vaginal estrogen therapy is not advised as it can cause endometrial cancer.
Are Hormone Patches Safe
Any type of HRT comes with some associated risks. But in most cases, the benefits of using menopause patches greatly outweigh any potential risks. Discuss your personal and family history and symptoms with your physician before using any type of HRT.
Transdermal estrogens increase the risk of developing blood clots, which is also a risk with most other types of hormonal treatments. This risk is rare in women aged 50 to 59 years old.;
Hormone patches could slightly increase the risk of breast cancer if theyre used for 5 or more continuous years. However, the risk decreases once HRT is discontinued. Its very important to carry out routine breast cancer screening whether youre taking HRT or not.
Women who are older than 65 years old could experience an increased risk of dementia while on HRT. Studies have found that using HRT for 5 to 7 years doesnt increase the risk of death. Transdermal hormones carry a lower risk of gallbladder disease than oral hormones.
Although more research is needed, its believed that several natural treatments can help relieve menopausal symptoms such as hot flashes and night sweats. Some natural treatments that may help relieve menopause symptoms include:
- Black cohosh
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Types Of Estrogen Replacement Therapy & Their Pros & Cons
Before starting on estrogen replacement therapy, it is important to consider a few things as to what type of it to opt for. There are many types of estrogen replacement therapy as well as forms in which they come, namely, pills, suppositories, patches and such.
It is also important to consult a doctor to make an assessment based on the patients health condition, the symptoms exhibited, and personal preferences. If a patient has not had a hysterectomy or surgical removal of the uterus and the ovaries, in that case, progestin is prescribed along with the estrogen to reduce the risk of developing endometrial cancer. Types of estrogen replacement therapy are:
What Are Fsa And Hsa Accounts
FSA’s and HSA’s are federal programs that make it easy for you to enjoy significant tax benefits for qualified out-of-pocket medical expenses. Each program works a little differently but with each you avoid federal, state and local income taxes on any funds that you use for qualified medical expenses.
FSA tax benefits are administered by your job. Funds in an amount that you decide âwithin the program limitsâare withdrawn from your paycheck without any payroll tax deductions.
Tax benefits with an HSA may be administered that way but there are also other options.
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How To Lower Your Estrogen Levels
There is a number of ways to directly or indirectly reduce excessive estrogen and avoid having high levels in the first place.
- Dont drink too much alcohol it is known to increase estrogen in men and women
- To prevent hypersensitivity in receptors, eat vegetables and nuts, and avoid dairy products .
- Avoid antibiotics and eat probiotic foods like kefir and kimchi. They promote healthy gut bacteria, which indirectly keep healthy estrogen levels.
- Reduce weight / keep healthy weight.
- Eat organic and dont use plastic-packed food they contain xenoestrogens which imitate estrogen and bind to cell receptors.
- Avoid hormonal birth control.
Selecting The Right Estrogen Replacement Therapy
Menopause is that time in a womans life when the ovaries stop releasing eggs. It is due to the reduced levels of the hormones estrogen and progesterone, which brings with it some unwanted symptoms. The symptoms include hot flashes, night sweats characterized by intense sweating, the sudden feeling of warmth over the face, neck and the chest, vaginal dryness which leads to painful sex. To help menopausal women get some relief from these symptoms, Hormonal Replacement Therapy is recommended. Through this treatment, the hormones estrogen and a synthetic version of progesterone called progestogen is used to replace and replenish the lowered levels of these hormones in the body.
Estrogen replacement therapy is one such way of administering this treatment, and here only the hormone estrogen is used in the form of pills, vaginal suppositories, rings, gels, creams, and sprays.
When it comes to choosing the right estrogen replacement therapy a lot of things need to be considered carefully. A patient with a family history of problems related to blood clots, liver disease, the stroke should be very careful in choosing an option that is right for them. For someone that has not had their uterus and ovaries removed surgically taking estrogen-only hormonal replacement therapy can lead to the risk of developing endometrial cancer.
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Other Factors To Remember:
Hormone replacement therapy works very well and has multiple different options you can choose from. Based on the cost of just the prescription, you may want to say the pills are your best bet. However, we want you to remember that there are other factors involved.
The cost of the doctors visit is not in the price of the prescription. If you have a co-pay for a doctors appointment, this can quickly add up to hundreds of extra charges for your therapy.
The same is true with bloodwork to monitor your levels. You have to pay for these tests, as many insurance companies have caps on how many blood tests they will pay for in a given year.
How Does The Birth Control Patch Work
The birth control patch prevents pregnancy by stopping sperm from joining with an egg .;
Like most birth control pills, the patch has the hormones estrogen and progestin these are similar to the hormones our bodies make naturally. The hormones in the patch stop ovulation. No ovulation means theres no egg hanging around for sperm to fertilize, so pregnancy cant happen. The patchs hormones also thicken the mucus on your cervix. This thicker cervical mucus blocks sperm so it cant swim to an egg kind of like a sticky security guard.
You;wear the Xulane or Twirla patch on your belly, butt, or back. You can also wear the Xulane patch on your upper arm. The hormones in the patch go into your body through your skin.
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Effects On Bone Mineral Density
There have been no bone efficacy and safety trials conducted with estradiol transdermal system. In a pharmacokinetic study, estradiol transdermal system was shown to be bioequivalent to Vivelle.
Efficacy and safety of Vivelle in the prevention of postmenopausal osteoporosis have been studied in a 2-year double-blind, randomized, placebo-controlled, parallel group study. A total of 261 hysterectomized and non-hysterectomized , surgically or naturally menopausal women , with no evidence of osteoporosis were enrolled in this study; 194 patients were randomized to one of the four doses of Vivelle and 67 patients to placebo. Over 2 years, study systems were applied to the buttock or the abdomen twice a week. Non-hysterectomized women received oral medroxyprogesterone acetate throughout the study.
Figure 3: Bone mineral density AP Lumbar spine
Least squares means of percentage change from baseline
All randomized patients with at least one post-baseline assessment available with last post-baseline observation carried forward
Figure 4: Bone mineral density Femoral neck
Least squares means of percentage change from baseline
All randomized patients with at least one post-baseline assessment available with last post-baseline observation carried forward
Addition Of A Progestin When A Woman Has Not Had A Hysterectomy
Studies of the addition of a progestin for 10 or more days of a cycle of estrogen administration, or daily with estrogen in a continuous regimen, have reported a lowered incidence of endometrial hyperplasia than would be induced by estrogen treatment alone. Endometrial hyperplasia may be a precursor to endometrial cancer.
There are, however, possible risks that may be associated with the use of progestins with estrogens compared to estrogen-alone regimens. These include an increased risk of breast cancer.
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Patient Assistance Programs For Estradiol Patch
Patient assistance programs are usually sponsored by pharmaceutical companies and provide free ordiscounted medicines to low income or uninsured and under-insured people who meet specific guidelines.Eligibility requirements vary for each program.
There are currently no Patient Assistance Programs that we know about for this drug.
How Should I Use Estradiol Patch
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Apply the skin patch to clean, dry skin on your stomach or buttocks. Press the patch firmly into place for at least 10 seconds. Choose a different spot within these skin areas each time you apply a new patch. Do not use the same skin area twice within 7 days. Avoid skin that is irritated or damaged.
Do not apply a skin patch to your breasts. Do not apply a patch where it might be rubbed off by tight clothing, such as under an elastic waistband. Never cut a skin patch.
If a patch falls off, try sticking it back into place. If it does not stick well, put on a new patch on a different skin area and leave it on only for the rest of your wearing time. Do not change your patch removal schedule.
Remove the patch and apply a new one on the same day each week to stay on your once-weekly or twice-weekly schedule.
Estradiol may increase your risk of developing a condition that may lead to uterine cancer. Your doctor may prescribe a progestin to help lower this risk. Report any unusual vaginal bleeding right away.
If you need major surgery or will be on long-term bed rest, you may need to stop using this medicine for a short time. Any doctor or surgeon who treats you should know that you are using estradiol.
Store patches at room temperature away from moisture and heat. Keep each patch in its pouch until you are ready to use it.
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