If hormone therapy is prescribed, a better choice may be the use of FDA approved plant-sourced estradiol products derived from yams or soy instead of conjugated estrogens sourced from horse urine. An example of these products include the oral medication Estrace, from Bristol-Myers Squibb, Vivelle or Estraderm from Novartis Pharmaceuticals, and Climara from Berlex Laboratories. Micronized progesterone is marketed under the prescription drug named Prometrium which is synthesized from Mexican yams.
Should estrogen be taken by patch or a pill?:
Goodman, MP performed a review of the available research between 1990 and 2010 including comparisons between oral and transdermal estrogen delivery. The author noted the following findings to support transdermal delivery over oral pills as the superior method (13,14):
- Transdermal estrogen does not require metabolism by the liver and results in more stable estrogen levels than oral estrogen.
- Transdermal estrogen may result in less production of inflammatory and pro-coagulant proteins by the liver compared to oral formulation.
- Transdermal estrogen might lower risk of weight gain and metabolic syndrome than oral estrogen.
- Transdermal estrogen may have less effect on lowering amount of free testosterone compared to the oral form.
Dose comparison of transdermal estrogen and oral estrogen:
A daily 50 mcg transdermal estradiol patch is approximately equivalent to Premarin at a dose of 0.625 mg daily.