Evorel (estradiol) is a Hormone Replacement Therapy (HRT) medication that supplies the body with the female hormone estrogen. It is most commonly prescribed for women experiencing symptoms such as hot flashes, difficulty sleeping, vaginal dryness and other symptoms commonly associated with menopause, though many women begin to experience these symptoms before menopause as the body's natural estrogen production begins to decline with age. It is also helpful in younger women who have had their uterus removed or who have other conditions that impair estrogen production.

This is an estrogen-only product. Women who have an intact uterus should not take an estrogen-only supplement without also taking a progestogen hormone. There is a significantly increased risk of developing serious complications, including some kinds of cancer, if a progestogen is not taken along with estrogen when the uterus is intact. There are two routes of treatment in these cases; patients can supplement estrogen-only medications with a separate progestogen product, or choose a combination treatment that combines estrogen and progestogen in the same product, such as Evorel Conti Patch. Patients who do not have a uterus do not need to worry about progestogen.

Product Overview

Evorel comes in patches. The patches are available in different dosage strengths which are indicated by a number in the product's name; this number describes how many micrograms of estradiol are released in a 24-hour period. In other words:

• Evorel 25 contains 1.6 mg estradiol, released at a rate of 25 micrograms in a 24-hour period.
• Evorel 50 contains 3.2 mg estradiol, released at a rate of 50 micrograms in a 24-hour period.
• Evorel 75 contains 4.8 mg estradiol, released at a rate of 75 micrograms in a 24-hour period.
• Evorel 100 contains 6.4 mg estradiol, released at a rate of 100 micrograms in a 24-hour period.

The ideal dosage strength should be determined by a doctor; treatment is highly variable depending on the severity of symptoms, other medical conditions which may be present, other medications being taken, and individual factors like age and weight. In otherwise healthy individuals treatment usually starts with Evorel 50; dosage may be adjusted after a few weeks when effects can be fully seen. Evorel patches alleviate a number of symptoms associated with reduced estrogen production:

• Hot flashes and night sweats
• Digestive problems
• Difficulty falling or staying asleep
• Moodiness
• Vaginal dryness
• Dry, brittle, and/or thinning hair, nails, and skin
• Loss of libido
• Headaches
• Osteoporosis

Patches are worn for 3 or 4 days and then replaced with a new patch. They should be placed on the trunk of the body below the waistline, and patches should placed on a new application site each time to prevent skin irritation. Evorel patches are waterproof and can be worn in the shower or bath, though excessive sweating may cause patches to fall off. If a patch does fall off it should be replaced with a new one.

Precautions & Adverse Effects

Most women find Evorel helps transition through menopause with minimal symptoms. However, some individuals are at significantly greater risk of experiencing complications from using this medication. Do not use this or any estrogen supplement without explicit doctor instruction if there is a history of:

• Breast cancer, including family history
• Blood clots
• Liver impairment
• Hypertension (high blood pressure)
• Diabetes
• Migraines
• Epilepsy
• Any heart problems
• Any circulation problems

In otherwise healthy patients side effects are rare, usually mild, and usually fade away as the body adjusts to treatment. The most commonly reported side effects include:

• Lightheadedness
• Headache
• Breast tenderness
• Mood swings
• Increased blood pressure
• Libido changes
• Vaginal thrush
• Fluid retention (edema)
• Abdominal upset

The above side effects are generally not cause for concern unless severe or persistent. Speak with a doctor if concerned; a dosage adjustment may help.