How long is it safe to continue to use a low-dose estrogen patch?

Question: How long is it safe to continue to use a low-dose estrogen patch?

Response:  The question, “How long is it safe to continue to use a low-dose estrogen patch?” is better rephrased, “How long does my body safely benefit from hormone therapy (HT)?”  Substantial research now supports the value of starting HT earlier, either in the late 40s or early 50s, to combat hot flashes, mood swings, memory changes, and skin and vaginal dryness, but there is also a risk to bone and cardiac health.  Earlier literature suggested that HT should be administered only for a few years.  But later studies followed women into their 60s and 70s to determine when they felt comfortable discontinuing HT.  To that end, a surprising number of women in their 60s and some even in their 70s still required HT, mainly to control hot flashes, depression, and vaginal dryness.  Notably, studies such as the Study of Women’s Health across the Nation (SWAN) and input from gynecologists caring for women over age 65 led The North American Menopause Society, in 2015, to state “with proper counseling and medical supervision. . .use of HT should be individualized and not discontinued based solely on a woman’s age.”  A woman who questions if she still needs her estradiol patch can ask that her patch dosage be decreased.  If she does not experience return of hot flashes, she may try to lower her patch dose further.  If hot flashes return, she can resume her HT and try this approach later. The guiding principal for hormone management in menopause should always balance risk versus benefit with the woman’s safety being the highest priority.

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James Woods | 3/28/2019