How to use Oestrogen Patches, Gel, Spray and Tablets
Article written by Dr Mari Walling, British Menopause Society Registered Specialist, GP, Co-founder of Lemala Health, November 2025. This information is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider for personal guidance.
This guide explains the differences between patches, gel, spray and tablets, how to use each one correctly, and how to choose the right type of oestrogen for your menopause symptoms.
Systemic oestrogen forms part of Hormone Replacement Therapy (HRT), also known as Menopause Hormone Therapy (MHT).
There are several ways to take oestrogen: Patches, gels, sprays and oral tablets are the most commonly used methods in the UK.
At Lemala Health, we generally prefer to prescribe what we call ‘transdermal’ oestrogen, which is oestrogen that is delivered via the skin into the bloodstream. These are the safest and most effective ways to replace oestrogen during perimenopause and menopause.
Transdermal oestrogen does not need to pass through your stomach or liver so you can take a much lower dose. Transdermal oestrogen appears to have little or no impact on clotting factors and so can be used safely in women with a history of blood clotting or migraines.
It can be used as a patch, gel or spray, and all three options contain body-identical 17β-oestradiol, the same type of oestrogen your ovaries naturally produce.
Oestrogen Patches
Oestrogen patches are applied as a translucent plaster.
Patches deliver a continuous dose of oestrogen and are changed once or twice weekly depending on the brand.
Patches can be particularly effective for migraine suffers, who benefit from the steady dose. They can be also helpful for women who prefer something low-maintenance or who want to avoid daily applications.
How to apply patches:
Apply to clean, dry skin below the waist - the hip, outer thigh, lower abdomen or buttock
Do not apply moisturiser or oils underneath.
Smooth the patch on firmly for 10–20 seconds.
Rotate application sites to reduce skin irritation.
They stay on through bathing, swimming and exercise.
If the patch falls off, put on a new one and continue your usual schedule.
A plaster mark will occur when they are taken off the skin, which can be removed using baby oil or eye make-up remover and a dry flannel.
Oestrogen Gel
Oestrogen gel is applied daily and absorbed quickly through the skin.
There are two gel preparations available, Oestrogel and Sandrena.
Oestrogel (pump), each pump contains 64 doses. Sandrena gel (sachets), come as sachets in two different strengths. There is less quantity of gel for the same dose compared to Oestrogel so it can be more practical in higher doses, or useful for travelling.
How to apply:
Apply daily and to clean dry skin. Usually in the morning, although you can be split it into morning and evening applications if preferred.
Applied to outer arms, or inner thighs. Spread the gel over a large area of skin.
Avoid applying to your breast and genital areas.
Try not to ‘stack your gel’, applying one pump/ one sachet of the gel per limb, depending on your dose as prescribed by you clinician.
Allow 2–5 minutes to dry before dressing.
Wait at least an hour after application before bathing or swimming.
Wash your hands afterwards.
Be careful not to transfer gel to partners, children or pets before it’s dry.
Oestrogen Spray (Lenzetto)
Lenzetto is a fine spray. It forms a “reservoir” under the skin, releasing oestrogen steadily over 24 hours.
Each bottle contains 56 sprays. How to apply spray
Before first use, prime the bottle by spraying three times with the cap on.
Apply daily to clean, dry skin on the inner forearm or inner thigh.
Spray onto a small circular area and avoid overlapping yesterday’s spot.
Allow to dry (~1 minute).
Avoid washing the area for at least 30 minutes.
Oestrogen tablets
Tablets can be convenient and are still widely prescribed in the UK – especially when other risk factors are low, if you have skin problems such as widespread eczema, or if you struggle to absorb transdermal products.
You usually take them once a day. Some of risks of HRT such as blood clots, are slightly higher than when using transdermal forms, although the overall risk is still minimal.
There’s also a new body identical tablet called Bijuve which is suitable for postmenopausal women and contains body identical oestrogen and progesterone.
And remember:
If you still have a womb, you will also need progesterone for endometrial protection. This can be taken as micronised progesterone capsules, a Mirena IUS, or within a combined patch.
This will be covered in a different resource.
There is no single “best” method. The right option is whichever you find comfortable, easy to use and effective.
It is important to take the medication as prescribed. Try and be consistent with whatever option you chose, stopping and starting, or forgetting will cause your hormone levels to fluctuate and may not help you feel well.
We would always advise women to try one and if you don’t get on well with it, you can try a different one, ideally after a few months of settling in.
References:
https://thebms.org.uk/wp-content/uploads/2024/02/15-BMS-TfC-HRT preparations-and-equivalentalternatives-JAN2024-B.pdf