In which situations is transdermal estrogen generally preferable?

Transdermal estrogen (such as patches, gels, or sprays) is generally preferable in certain situations, especially when minimizing the risk of blood clots is important. Here at Alloy, we recommend considering transdermal options if you:

Have high blood pressure
Are sedentary
Have Type-2 Diabetes or are at high risk for developing it
Have a strong family history of heart attack, stroke, or blood clotting disorders
Are over 70, are starting Menopausal Hormone Therapy (MHT) after age 60, or are starting MHT more than 10 years after your last period
Smoke, as this increases your baseline risk for blood clots

Transdermal estrogen is absorbed through the skin and bypasses the liver, so it does not activate clotting factors, making it a safer choice for those with increased clotting risk. It also provides more stable hormone levels, which can be especially helpful for people who are sensitive to fluctuations, such as those who experience migraines.

If you want to learn more about the different forms of estrogen therapy and which might be right for you, check out our detailed guide: Estradiol Patch vs. Pill vs. Spray: What’s right for me?

You can also explore our transdermal options:

For a helpful video explanation, watch the "Special Considerations" chapter in Dr. Sharon Malone's YouTube video, which covers when transdermal estrogen is preferable. Watch the relevant chapter here.

If you’re unsure which option is best for you, start with our quick online assessment and connect with a menopause-trained Alloy doctor for personalized recommendations.

This answer was created using the following resources: