Estradiol Patch to Gel Conversion

Conversion Rationale

• The American College of Obstetricians and Gynecologists implies that half of an Evorel 75 patch (37.5 mcg/day) converts to approximately 0.5-0.75 mg of Estrogel daily, as standard transdermal patches releasing 50 mcg/24 hours are considered equivalent to 0.5-1 mg of transdermal gel daily 1, 2

Specific Dosing Recommendation

• The Endocrine Society suggests starting with 0.5 mg Estrogel daily as the most conservative equivalent dose, and if symptoms persist after 2-3 months, increase to 0.75 mg daily 1

Application Instructions

• The North American Menopause Society recommends applying Estrogel to clean, dry skin on the lower abdomen, upper outer arm, or thighs, and rotating application sites to minimize skin irritation 1

Critical Endometrial Protection

• The American College of Cardiology and other organizations agree that if you have an intact uterus, you must add progestin supplementation to prevent endometrial hyperplasia and cancer, with options including micronized progesterone 200 mg orally or vaginally for 12-14 days every 28 days, medroxyprogesterone acetate 10 mg daily for 12-14 days per month, or dydrogesterone 10 mg daily for 12-14 days per month 1, 2, 3

Monitoring and Titration

• The European Menopause and Andropause Society suggests assessing symptom control after 2-3 months on the initial dose 1