Estradiol and Norethisterone Acetate 

Estalis 

Estalis is an FDA-approved hormone replacement therapy medication that is used to provide relief from moderate to severe menopausal symptoms such as hot flashes, vaginal dryness, and trouble sleeping, along with vulval and vaginal atrophy. The prescription medication contains two ingredients: estradiol and norethisterone acetate. It is available in the form of extended-release stick-on patches with strengths of 50mcg/140mcg and 50mcg/250mcg. When you apply an Estalis patch to your skin, it releases the hormones into your bloodstream through your skin. This medication is not recommended for use in pediatric patients. Consult a licensed healthcare provider with any queries or concerns regarding medication usage and dosage. To ensure that the medication you are using is authentic and safe, you can buy Estalis patches online from reputable and trusted sources. 

Product Overview

Estalis is a hormone replacement therapy (HRT) medication designed to alleviate moderate to severe menopausal and post-menopausal symptoms, such as difficulty sleeping, hot flashes, and vaginal dryness, as well as vulval and vaginal atrophy. It contains two main ingredients: estradiol, a form of estrogen that helps replenish hormone levels, and norethindrone acetate, a progestin that provides protection for the uterus by balancing the effects of estradiol.

Estalis is available in extended-release stick-on patches with strengths of 50mcg/140mcg and 50mcg/250mcg. Adults should apply one patch twice weekly for a 28-day treatment cycle, replacing it every three to four days on the same day of the week. It is not recommended for use in children. The patches are applied to clean, dry areas of the abdomen or buttocks, avoiding the breasts or areas where clothing may rub.

Common side effects include irregular vaginal bleeding, breast tenderness, headache, nausea, and mood changes. Precautions include monitoring for increased blood pressure, risk of blood clots, and breast cancer. If you miss a dose, apply it as soon as you remember, but skip it if it’s almost time for the next dose. Overdose is unlikely due to the application method, but immediate medical help is required if ingested. Store Estalis in its original container in a cool, dark, and dry place, away from light and out of reach of children. Consult your healthcare provider for more detailed guidance on usage and potential interactions.

What Are the Uses of Estalis?

It is used to treat:

• Moderate to severe menopausal & post-menopausal symptoms such as hot flashes, difficulty sleeping, and vaginal dryness
• Vulval and vaginal atrophy

What Are the Forms & Strengths of Estalis?

It comes in the form of extended-release stick-on patches with the strength of:

• 50mcg/140mcg 
• 50mcg/250mcg

What Are the Recommended Dosage of Estalis?

The dose of Estalis depends on various factors, including the patient’s age, weight, and condition. Initially, your doctor may prescribe a starting dose and gradually adjust it accordingly based on your response to the treatment. Therefore, it is crucial to talk to a medical expert before starting estradiol treatment. The following section covers only the average dose of Estalis, so if you have been prescribed a different dose, do not panic; follow the schedule exactly as your doctor instructed.

For Treatment of Menopausal Symptoms

• Adults should apply one patch twice weekly for a 28-day treatment cycle. (One patch contains 0.05 mg of estradiol and 0.14 or 0.25 mg of norethindrone).
• Replace the patch every three to four days on the same day of the week. 
• Estalis is not recommended for use in children. 

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Use Estalis? 

• Before you decide to buy estradiol for menopause, you should carefully read and follow the instructions for use given in the patient information leaflet that came along with this medication or provided by your healthcare provider or pharmacist.
• Your medication dosage is based on many factors, such as body weight, needs, and other medical conditions and medications you may take to treat the condition. 
• One 28-day treatment cycle with Estalis consists of eight patches. 
• You can apply one patch to your skin twice weekly, always on the same days and at the same time of the week, and change the patch every 3-4 days.  
• Once your 28-day treatment cycle is complete, you can start a new package with new patches. 
• You should apply a new patch on your abdomen or buttocks. If you have concerns about the areas of skin where patches should be applied, consult your doctor. 
• Do not apply it to your breasts or areas of the skin where your clothing may rub the patch off or where the skin is folded or very hairy. 
• During the initial few months, you are most likely to experience some bleeding or spotting at odd times, which is not usually a cause of concern. Over time, the bleeding becomes lighter and eventually stops. Tell your doctor if you experience heavy or abnormal bleeding. 
• Do not share your medications, including Estalis, with others, even if they have the same symptoms as you do. 
• Do not use this medication to treat any other condition unless your doctor tells you otherwise. 

To apply the Estalis patch, you can follow the directions given below:

• Wash your hands properly before and after using the Estalis patches.
• Select a clean and dry skin area that is not damaged, oily, irritated, or exposed to the skin. The area should be free of oils, lotions, moisturizers, and lotions. 
• To avoid accidentally cutting the patch, open it at the notch rather than using scissors, as if it is cut, you will not be able to use it. 
• To separate the patch from the protective liner, hold it facing you, peel off one side of the liner, and dispose of it. 
• Using the other half of the liner as a handle, immediately apply the patch to the selected area and smooth it down. Avoid touching the adhesive, fold back the patch’s other side, and remove the other side of the liner. 
• Use your fingers to hold the patch in place for about ten seconds and ensure it is affixed to your skin, especially around the edges. 
• While replacing the patch, carefully fold the adhesive side inwards and remove the old patch, ensuring that any remaining adhesive is removed with baby oil, rubbing alcohol, or mineral oil. 
• Throw the unwanted patch safely away from the sight of children and pets. 
• Showering, bathing, swimming, or other contact with water does not affect the patch. Steam or hot water, though, might loosen it.
• If your patch falls off, try reapplying it. If it does not stick, apply the new patch and continue your schedule. 
• If the patch consistently comes off in hot baths, saunas, or whirlpools, consider removing it after a short time in the water. 
• If you remove the patch temporarily, you should cover the adhesive with the protective liner or use wax paper to prevent the medication from evaporating while you are not using the patch. 

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Estalis Work?

Estalis works by delivering two essential hormones- estradiol and norethindrone acetate through a transdermal patch. Estradiol is a type of estrogen naturally produced by your ovaries. Estalis patches release controlled amounts of estradiol through your skin, allowing it to enter your bloodstream. On the other hand, Norethindrone acetate is a progestin. When combined with estradiol, it protects your uterus. This is crucial because unopposed estrogen therapy can increase the risk of uterine cancer. NETA balances the effects of estradiol and ensures overall safety.

Important Safety Information for Using Estalis

What Are the Side Effects of Estalis?

Common Side Effects: All medications have some side effects that usually do not require medical attention. These are known to be as common side effects. Such effects occur when your body adjusts to the medication and disappears within a few days or weeks. However, you should tell your doctor if these symptoms persist or have become bothersome. Some people may experience side effects that are not listed here. You should report such symptoms to your doctor. The common side effects caused by Estalis are as follows:

• Breast Pain: This medication contains hormones that affect breast tissue, leading to increased blood flow and growth. Such hormone changes make breasts swollen, sensitive, and tender. 
• Irregular Vaginal Bleeding: Hormonal changes may affect the uterus lining, causing unexpected bleeding or spotting during periods. This side effect is very common at the initial stage of the treatment. So, when you decide to buy Estalis patch for menopause, beware of such side effects.
• Headache: Estradiol can cause hormonal fluctuations, affecting blood vessels in the brain. These changes may sometimes lead to headaches. You may experience mild to moderate headaches during your treatment, which can be avoided if you stay hydrated. 
• Nausea: Some patients may feel nauseous after using this medication, as its hormones can upset the stomach. This is the most common side effect during the starting stage, which will disappear after some time. To avoid this feeling, eat small and frequent meals. 
• Abdominal Pain: An affected digestive system results in abdominal pain, which usually happens due to hormonal changes. This pain is accompanied by stomach discomfort or cramps. If the pain becomes severe, get medical help.
• Bloating: When your body accumulates more water than usual, it can cause bloating. Many patients experience this side effect during their treatment. Doctors generally advise drinking enough water and reducing salt intake to prevent bloating.
• Fluid Retention: Estalis can lead to fluid retention, causing swelling in different body parts, especially hands or feet. In such situations, avoid standing for long periods; this will reduce swelling. 
• Mood Changes: Hormones play a major role in regulating your mood, and when there are fluctuations in these hormones, it affects neurotransmitters that are responsible for mood regulation. Thus, you feel mood changes when using Estalis. 

Serious Side Effects: The risk of severe side effects may increase with factors such as age, smoking, obesity, and personal or family history of certain conditions. Call your doctor or go to the nearest emergency room if you experience any of the following serious symptoms:

• Allergic Reactions: Estalis users have also reported severe hypersensitivity reactions after using the medicine. These reactions manifest as itching or hives on the skin, rash, swelling of the face, lips, and tongue, breathlessness or trouble breathing, wheezing or coughing, light-headedness, dizziness, unconsciousness, hypotension, with or without mild generalized itching, and skin reddening.
• Blood Clotting: These estradiol patches increase the risk of blood clots, leading to serious complications like deep vein thrombosis or pulmonary embolism. Some of its symptoms may include sudden severe headache, loss of coordination, coughing blood, blurred vision, sudden blindness or any other vision changes, slurred speech, painful swelling in the calves or thighs, numbness or a feeling of tingling in the arm or leg, angina (chest pain), and difficulty breathing.
• Nipple Discharge: It is a sign of hormonal imbalance, which generally happens due to Estalis. Check it with a doctor to rule out any serious complications.
• Vaginal Irritation: Estradiol can disturb the vaginal lining, irritating your vagina. You may also experience dryness, itching, or discomfort. 
• Severe Stomach Pain: This side effect is accompanied by loss of appetite, fever, nausea, and vomiting. 
• Jaundice: If you notice yellowing of the eyes, dark-colored urine, itching, or light-colored bowel motions, you may have liver issues. These symptoms necessitate immediate medical attention. 

[Note: This list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Are There Any Warnings for Estalis? 

Before you buy Estalis patches online, tell your doctor about any medical conditions or allergies you may have, medications you may be taking, your pregnancy or breastfeeding status, and other significant facts related to your health, as these factors may affect usage.

Important Information on Estrogen Replacement Therapy:

The Women’s Health Initiative (WHI) study indicated increased risks (heart attack, stroke, breast cancer, blood clots) with 0.625 mg conjugated estrogens & 2.5 mg medroxyprogesterone. Assume similar risks for other hormone products. You should use estrogen at the lowest effective dose for the shortest duration, exactly as directed by your doctor. It is not recommended for preventing heart disease or strokes with or without progestin.

• Allergy: Contact allergy is rare but possible. Severe reactions may occur with continued use. You may require a doctor’s consultation if you experience persistent redness or itching at the patch site.
• Blood clots: Estalis can increase the risk of blood clots if you have or have ever had heart issues, blood clots, or certain medical conditions. There is a higher risk of getting blood clots with severe varicose veins, obesity, a family history of blood clots, prolonged immobility, or major surgery. Discontinue using the medication four weeks before major surgery.
• Blood pressure: This medication can increase the blood pressure. Monitor your blood pressure carefully before and during use.
• Bone disease: Discuss with your doctor if you have bone disease or high calcium levels to know how this medication will affect your medical condition.
• Breast cancer: Long-term use of estrogen replacement therapy increases the risk of breast cancer. Discuss with your doctor if you have breast nodules, abnormal mammograms, or a strong family history. Regular mammograms and breast examinations are recommended while you are using this medication.
• Dementia: Individuals over age 65 receiving combined HRT have an increased risk of dementia. Discuss concerns with your doctor.
• Diabetes: Estrogen may affect blood sugar control. Monitor blood glucose levels if at risk or diabetic.
• Endometrial cancer: Using estrogen without progestin has an increased risk of developing endometrial cancer. Abnormal vaginal bleeding while using this medication requires a doctor’s consultation.
• Fibroids: Estalis may worsen fibroids. Contact your doctor if symptoms arise, such as sudden pain, tenderness, or enlargement.
• Fluid retention: Estrogen may worsen heart, kidney, or asthma conditions. Consult your doctor if conditions worsen while using this medication.
• Follow-up: It is essential to have a follow-up examination every 3 to 6 months after starting Estalis, then annually.
• Gallbladder disease: This medicine may increase the risk of developing or worsening this condition. Discuss if you have gallbladder disease.
• Heart disease & stroke: Studies indicate an increased risk of cardiovascular disease with estrogen. Seek immediate medical attention if symptoms of heart attack occur.
• High cholesterol/Triglycerides: May increase levels, especially with oral estrogen. Discuss monitoring.
• Kidney function: This medication may affect calcium and phosphorus levels. Special monitoring may be needed.
• Liver function: Avoid using this medication if you have reduced liver function. Monitor liver function if you have liver issues.
• Migraine headaches: You should not use this medication if you have migraines with aura. Estrogen may aggravate migraines without aura.
• Ovarian cancer: The chance of getting cancer of the ovaries with long-term use of estrogen is higher. Avoid using this medication if you have a history of ovarian cancer.
• Seizures: Estrogen may increase seizure risk. Special monitoring may be needed if you have a seizure disorder.

What Are the Estalis Precautions?

Like all medications, these hormonal patches can cause complications to their users. To avoid such risks, follow the below precautions:

• Before using this medication, share your complete medical and personal history with your doctor and let them know if you are pregnant, breastfeeding, or if you have any allergies.  
• Tell your doctor if you have ever had any abnormal or allergic reactions to Estalis or any of its ingredients in the past or if you have any other allergies. Also, tell them if you have any unusual or allergic reactions to foods, medications, dyes, animals, or preservatives. You can ask your physician, pharmacist, or healthcare provider for the full list of ingredients.
• You should visit your doctor on regular basis to make sure this medicine works properly and check your progress. Your doctor may suggest that you have a mammogram, pelvic exam, and breast exam to look for unwanted side effects. 
• It is nearly impossible for a post-menopausal woman to become pregnant. However, you should know that you should not use this medication while you are pregnant as it may harm the unborn baby. If you suspect a pregnancy, tell your doctor immediately. 
• Using this medication may increase your risk of endometrial cancer, breast cancer, or uterine cancer. Consult your doctor regarding this risk. If you have abnormal or severe bleeding, you should consult your doctor. 
• You should not use Estalis if you have had a hysterectomy. 
• Call your doctor immediately if you experience sudden vision loss, severe headache, or any other vision change while using this medication.
• Estalis may cause serious allergic reactions, including anaphylaxis, which may be fatal and require immediate medical attention. Call your doctor immediately if you experience itching, hoarseness, rash, light-headedness, trouble breathing, difficulty swallowing, dizziness, or swelling of your hands, mouth, or face. 
• If you plan to have surgery, including a dental procedure, you should tell your doctor, surgeon, or dentist about all the medications you are taking, including Estalis. Also, tell them about all the prescription, over-the-counter drugs, and vitamin or herbal supplements you may be taking. You may be asked to stop using this medication before you have surgery or if you are required to stay in your bed for an extended period. 
• It is noteworthy to mention that this medication can affect the results of certain tests. 
• You should not consume grapefruit juice or grapes while you are receiving treatment with Estalis, as they may affect the amount of medication that is absorbed in the body. 
• You should not take other medications unless your doctor has asked you to. This includes all prescription, non-prescription, over-the-counter drugs, and vitamin and herbal supplements you may be taking. 
• Geriatric patients have an increased risk of breast cancer, strokes, or dementia and may require close attention while taking this medication. 
• Before breastfeeding a baby, you should consult your doctor to determine the potential risks associated with the use of this medication and use it only after weighing the potential risks with benefits. 

What Are the Contraindications of Estalis?

If you fall under any of the below categories, do not buy estradiol for menopause:

• Patients with active or recent arterial thromboembolic disease
• Patients with known or suspected estrogen-dependent malignant tumors
• Those with a history of breast cancer or known or suspected breast cancer
• Have an undiagnosed abnormal genital bleeding
• Have an untreated endometrial hyperplasia
• Previous or current venous thromboembolism (deep vein thrombosis, pulmonary embolism)
• Liver disease that is either acute or has previously occurred and has not improved the liver’s function tests
• Known hypersensitivity to any of the active substances or excipients in Estalis
• Porphyria
• Pregnancy or suspected pregnancy
• Lactation (breastfeeding)
• Severe kidney dysfunction or acute kidney disease

What If You Missed a Dose of Estalis?

• If you have forgotten to apply your patch, you should use it as soon as you remember. 
• However, if it is almost time to apply your patch, you should skip it and apply it according to your medication schedule. 
• If you have trouble determining when to replace your patch, ask your doctor, pharmacist, or healthcare provider. 
• If you often forget missing doses of Estalis, you should try setting a medication reminder on your phone. 

[Note: If you have missed a medication dose and are unsure when to take the next one, immediately consult your doctor or pharmacist.]

What Happens If You Take Too Much of Estalis?

Due to the way this medication is used, an overdose is unlikely to occur. If someone accidentally swallows the Estalis patches, they may experience nausea and vomiting. If you suspect an overdose, you should immediately seek medical help. You can call your doctor, poison control helpline, or 911. You can also head to the nearest emergency room. 

[Note: If you consumed more than the recommended dose, get medical help immediately or call the Poison Help line at 1-800-222-1222.]

How to Store an Estalis?

If you plan to buy Estalis patches online, you must know the following storage guidelines. This information helps maintain the safety and effectiveness of the medication:

• Keep Estalis in its original container in a cool and dry place unless you are ready to use it. You can keep it in the refrigerator until you open the patch package. 
• Keep this medication at a controlled room temperature, away from direct sunlight, excess heat, and moisture, for up to six months or before the expiration date mentioned in your prescription label or carton, whichever comes first. 
• Do not keep it in the bathroom or near the sink. 
• Do not leave Estalis in the car or on window sills.
• Store all medications, including Estalis, in a safe place away from the sight and reach of children. 
• Do not keep medications that are outdated or no longer needed. Discard them safely. 
• Do not pour it down the drain, throw it in the household garbage bin, or flush it down the toilet. 
• You can fold the patch in half with the adhesive side together to discard it. Otherwise, keep it in a child-proof container and throw it in the trash, away from the reach of children and animals. 
• Consult your healthcare provider, pharmacist, or local waste disposal company to learn how to eliminate unwanted medications properly.  

[Note: Discuss with your healthcare professional the proper disposal of unused medicine and any questions you may have regarding its storage.]

What Medications Interact with Estalis?

The following drugs may interact with Estalis and affect how it may work. Based on your medical condition and needs, your doctor may ask you to stop taking one of the medications, change the medication or dosage, or leave it as it is. So, when you decide to buy estradiol for menopause, ask your doctor about its drug interactions. 

• Anastrozole 
• Apalutamide 
• Aprepitant 
• “Azole” antifungals
• Bosentan 
• Carbamazepine 
• Celecoxib 
• Clarithromycin 
• Cobicistat 
• Corticosteroids 
• Diabetes medication 
• Elagolix 
• Enzalutamide 
• Eslicarbazepine 
• Heparin 
• HIV non-nucleoside reverse transcriptase inhibitors 
• HIV protease inhibitors
• Hyaluronidase 
• Lamotrigine 
• Lenalidomide 
• Lumacaftor and ivacaftor
• Melatonin 
• Mifepristone 
• Modafinil 
• Muscle relaxants 
• Nirmatrelvir 
• Ospemifene 
• Phenobarbital 
• Phenytoin 
• Primidone 
• Progesterone 
• Rifabutin 
• Rifampin 
• Ropinirole 
• St. John’s wort
• Somatropin 
• Tacrolimus 
• Thalidomide 
• Theophyllines 
• Tranexamic acid
• Thyroid medications
• Tyrosine kinase inhibitors
• Ulipristal 
• Ursodiol 

What Are the Other Estalis Interactions?

Before taking this medication, you should tell your doctor, healthcare provider, or pharmacist about all the medications you are currently taking or planning to take, including all prescription, non-prescription, over-the-counter, and vitamin or herbal supplements. Also, tell them if you consume caffeine, alcohol, tobacco, or marijuana (cannabis). 

[Note: This isn’t a complete list, and there could be other drugs that interact with Estalis. Tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

What Are the Estalis Alternatives?

There are many efficient alternatives to Estalis available in the market. You should always consult your doctor before starting to take a new medication or changing your dose. Some of the alternatives to Estalis are listed below. 

• Climara (estradiol hemihydrate)
• Vivelle-Dot (estradiol)
• Estraderm (estradiol)
• Alora (estradiol)
• Minivelle (estradiol)
• Combipatch (estradiol/norethindrone acetate)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

Estalis Cost & Coupons

The cost of Estalis and options for obtaining it at a lower price are influenced by various factors, including health insurance coverage. Many Americans find that their health insurance does not cover medications like Estalis, leading to high out-of-pocket expenses. To manage these costs, some Americans turn to services like Polar Bear Meds, where they can buy Estalis patches for menopause directly from Canada at a reduced price. Additionally, customers can use the Estalis coupon code WELCOMEPB10 to receive a 10% discount on their first order.

Frequently Asked Questions

Where is the best place to put an Estalis patch?

The best place to apply an Estalis patch is on the lower abdomen, hip, or buttock. These areas are ideal as they have less movement, and you are less likely to have irritation. Do not wear it around the waistline, as clothing may rub against the patch. Lastly, to avoid any skin issues, rotate the site when applying a new patch.  

Can Estalis cause hair loss?

While not common, Estalis can cause hair loss in some patients because the hormones in this medication may affect your hair growth cycle. Consult a medical provider if you suspect any major hair thinning or loss. They will suggest possible solutions to avoid such conditions.

How long does it take for Estalis to start working?

Estalis typically begins to alleviate menopausal symptoms such as vaginal dryness, hot flashes, and difficulty sleeping within a few weeks of starting the treatment. The full therapeutic effects may take up to three months to become evident. Following the prescribed treatment cycle is essential, and consult your healthcare provider if you don’t notice any improvement or if your symptoms worsen.

Can Estalis patches be used if I have a history of blood clots?

Particularly in individuals with a history of deep vein thrombosis, pulmonary embolism, or other clotting disorders have a higher risk of blood clots while using this medication. If you have a history of blood clots or are at high risk, discuss with your doctor whether Estalis is appropriate for you and explore possible alternatives or additional precautions to mitigate this risk.

How often do I change Estalis patches?

When you decide to buy Estalis patches for menopause, you must know the duration of its usage. Doctors usually advise changing the patches every 3 to 4 days. However, reapplying also depends on the brand of product you use. Make sure that you follow a consistent schedule when changing your patches. If you are still unsure about the days, talk to your doctor.

Are there any dietary restrictions while using Estalis?

While using Estalis, it is recommended to avoid grapefruit & grapefruit juice, as they can interfere with the medication’s absorption and effectiveness. Additionally, maintaining a balanced diet and monitoring your consumption of meals rich in calcium & vitamin D can support bone health, especially if you are at risk for osteoporosis. Always consult a licensed healthcare provider for customized dietary advice.

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