British Menopause Society guidelines
Systemic HRT for symptom control should be used for as long as the benefits of symptom control and improvement in quality of life appear to outweigh any risks. For symptom control, it is recommended to start with a low dose preparation.
Systemic HRT treatment:
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Indications for transdermal therapy
- Individual preference
- Poor symptom control with oral therapy
- GI disorder affecting oral absorption
- Previous or family history of VTE
- BMI >30
- Variable blood pressure control
- Migraine
- Current use of hepatic-inducing enzymes medication
- Gallbladder disease
In a non-hysterectomised setting, ie for the majority of women, a progestogen is recommended in addition to estrogen.
Total transdermal administration:
Currently, only Evorel® Sequi, Evorel® Conti and FemSeven® Conti offer transdermal delivery of both estrogen and progestogen.