Climara and weekly hot flashes
Drop in the average number of hot flashes a week over an 11-week trial in 214 women, who started with 46 to 53 a week.
Climara prescribing information, clinical studies, DailyMed.
An FDA-approved generic, dispensed by a licensed US pharmacy we chose. See which one
Women's health
Estradiol patch
FDA-approved generic estradiol patch, once or twice a week
An estradiol patch you change once or twice a week, for hot flashes and other menopause symptoms. Prescribed by a Seattle provider and dispensed by a licensed US pharmacy we chose.
$133/month
With the 3-month plan. $149 month to month.
- Online or video visit with a Seattle provider
- Medication from a pharmacy we chose
- Follow-ups in your patient portal, as often as you'd like
You only pay if a provider prescribes.
Every prescription gives 50 meals a month to those in need.
What it is
How the estradiol patch works
Estradiol is the main estrogen your ovaries made before menopause. The patch sits on your skin and releases estradiol through it into your bloodstream, and you change it once or twice a week.
Hot flashesHot flashes and night sweats
The FDA label lists treatment of moderate to severe hot flashes due to menopause.
VaginalChanges in and around the vagina
The label also lists moderate to severe vaginal and vulvar symptoms of menopause. If those are your only symptoms, it says to consider a vaginal product first.
Prefer something you apply once a day? See estradiol gel
How you apply it
Your patch is changed once or twice a week, depending on which patch your provider prescribes. Your provider sets your strength with you, and your pharmacy label shows the exact strength and your change days.
Twice-weekly patch
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Once-weekly patch
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Change dayKeep wearing
Example change days. Your pharmacy label shows yours
- Pick a spot
Choose a clean, dry area of your lower stomach or buttocks that isn't oily, irritated or broken. Skip your waistline, where clothes can rub the patch off, and never put it on or near your breasts.
- Open it and put it on
Open the pouch, peel off the liner and put the patch on right away. Patches should stay sealed in their pouches until you use them.
- Press for 10 seconds
Press it firmly in place for about 10 seconds, making sure the edges stick well.
- Move to a new spot each time
Wait at least a week before you use the same spot again.
- Change it on your day
Peel the old patch off slowly, fold it in half so the sticky sides meet, and put it in the trash out of reach of children. Don't flush it. Put the new one on a new spot.
Steps from the FDA prescribing information for Climara (once weekly) and Vivelle-Dot (twice weekly), the brands behind the two FDA-approved generic patches. Your provider's directions and your pharmacy label come first.
The researchCompared with placebo Compared with placebo Skin compared with pills Society position
What the studies found
Estradiol patches were approved by the FDA on the strength of placebo-controlled trials. The trials below come from the FDA labels for Climara and Vivelle, the brand-name patches studied. Your patch is an FDA-approved generic.
Vivelle at its lowest dose
The 0.0375 mg patch reduced how often and how strongly hot flashes came, compared with placebo.
A 12-week trial in 255 women who started with about 11.5 hot flashes a day. The label reports that every Vivelle strength studied controlled hot flashes.
Vivelle-Dot prescribing information, clinical studies, DailyMed.Route and blood clots
0.9Estrogen through the skin
4.2Estrogen by mouth
Odds of a blood clot in a vein compared with women not using estrogen, in the French ESTHER study of women after menopause. ACOG reads 0.9 as no increased risk.
ACOG Committee Opinion 556, reaffirmed 2020, citing Canonico et al., Circulation 2007. ACOG.The Menopause Society, 2022
"Hormone therapy remains the most effective treatment for vasomotor symptoms (VMS) and the genitourinary syndrome of menopause"
For women younger than 60, or within 10 years of menopause onset, with no contraindications, the statement calls the benefit-risk ratio favorable for bothersome hot flashes and preventing bone loss.
The 2022 hormone therapy position statement, Menopause 2022. PubMed.Trial results describe the brand-name patches studied, Climara and Vivelle, over 11 to 12 weeks. ESTHER compared routes of estrogen as groups and did not study one patch. Individual results vary.
First weeks
What to expect in your first weeks
The first weeks are about settling into your change days. Here's what happens, in order.
- Before day 1Your patches arrive
Your pharmacy ships your patches in sealed pouches. Keep them at room temperature, in their pouches, until you use them.
- Day 1Your first patch
Pick your change day, or days, and put your first patch on a clean, dry spot. Coming off estrogen tablets? Your provider will tell you when to start.
- First weeksWhat's common
Headache, breast pain, irregular vaginal bleeding or spotting, stomach cramps or bloating, nausea, and redness or irritation where the patch sits are common side effects listed on the label.
Moving to a new spot each time, as the label directs, gives your skin a rest. If a side effect doesn't settle, message your provider in your patient portal.
- After you startChecking in
Questions about your strength, your skin or how you are feeling go to your provider in your patient portal. You can also book a video visit at no extra cost.
Patch came off, or forgot to change it?
Press it back on, or put on a new patch in a new spot, and keep your usual change days. If you forgot, put a new one on as soon as you remember. Gaps can bring back spotting or symptoms.
Have a uterus?
Your provider will talk with you about progesterone, which the label says to consider with estrogen to lower the chance of cancer of the uterine lining. See progesterone capsules
Get medical help right away
For chest pain, pain or swelling in your legs, sudden shortness of breath, changes in vision or speech, or a sudden severe headache.
From the FDA prescribing information for Climara and Vivelle-Dot. Your provider's directions and your pharmacy label come first.
How it works
Choose how you meet your provider
StartPick a treatmentAnswer a few health questions online. No office visit and no insurance needed.
OnlineProvider reviewA Seattle provider reviews your answers and messages you if they have questions.
VideoMeet your providerBook a video visit if you'd rather talk it through face to face.
PrescriptionPay only if prescribedYour visit, online or on video, is included in the treatment price. If a provider doesn't prescribe, you're not charged.
DeliveryFilled and shippedThe pharmacy we chose for your treatment fills it and ships it to your door.
After deliveryOngoing careFollow up with your provider in your BrightSide patient portal as often as you'd like.
Who is behind itYour pharmacy 
Your providers
Who fills it and who prescribes it
Our pharmacies
We grade the pharmacies we work with in five categories. More than eighty compounding pharmacies have been through our grading so far.
- What we look atWho they are, what they can make, their record, where the ingredients come from and whether it works in practice.
- Named on our siteOur pharmacy network page names each pharmacy that fills orders today and why we chose it.
- Licensed US pharmaciesEvery prescription is filled by a licensed US pharmacy we chose.
Arora Health, Seattle
A physician-led medical group. A licensed provider reviews every visit and every dose change.
- Dr. Shannon Arora, MDChief medical officer, Arora Health
- Dr. Sean AroraFounder, Arora Health
Support
Support once you start
Your patient portalFollow up with your provider in your BrightSide patient portal as often as you'd like.
Video visitsBook a video visit with a provider at no extra cost.
A person, by emailEmail hello@jointhebrightside.com and a person answers.
The same providers, after you start
A licensed provider from Arora Health in Seattle reviews every visit and every dose change. Questions about your dose, side effects or what comes next go to them in your patient portal.
Questions
Estradiol patch questions
Is the estradiol patch FDA approved?
Yes. Your patch is an FDA-approved generic estradiol transdermal system, made by a drug manufacturer and dispensed by a licensed US pharmacy we chose. It is not compounded.
Is it once a week or twice a week?
It depends on the patch your provider prescribes. One generic is changed once a week and the other twice a week. Your pharmacy label shows your change days.
Do I need progesterone too?
If you have a uterus, your provider will talk with you about progesterone. The label says to consider adding a progestogen for women with a uterus, to lower the chance of cancer of the uterine lining. See progesterone capsules
Should I choose a patch or a tablet?
In the ESTHER study, women taking estrogen by mouth had higher odds of a blood clot in a vein than women not using estrogen, and women using estrogen through the skin did not. Your provider weighs your history with you. See estradiol tablets
Can I shower or swim with it on?
The two labels differ. The twice-weekly patch's label says showering won't make it fall off. The once-weekly patch's label says water from swimming, a sauna, a bath or a shower may loosen it. Check your patch afterward and press it down if it lifts.
Which pharmacy fills my prescription?
A licensed US pharmacy we chose. Our pharmacy network page names each pharmacy that fills orders today and its licenses.
How is it shipped?
Your pharmacy ships your patches in their sealed pouches. Keep them at room temperature until you use them. If anything about your delivery looks off, email hello@jointhebrightside.com before you use it.
Do I need insurance?
No. Insurance isn't needed, and your visit, online or on video, is included in the treatment price.
What if the provider says no?
You're not charged. Your card is only charged if a licensed provider prescribes your treatment.
FDA-approved estradiol patch, prescribed in Seattle
$133/month
With the 3-month plan. $149 month to month.
You only pay if a provider prescribes.
Important safety information
Estrogen alone increases the chance of cancer of the lining of the uterus in women who have a uterus. Adding a progestogen lowers the chance of a thickening of the lining that can lead to cancer. Report any unusual vaginal bleeding to your provider right away. If you have a uterus, your provider will talk with you about progesterone.
The current FDA label also carries boxed warnings about heart and blood vessel problems, probable dementia and breast cancer, based on the Women's Health Initiative, which studied daily oral conjugated estrogens with or without medroxyprogesterone acetate. In that study, estrogen alone raised the risk of stroke and blood clots in the legs. Estrogen with a progestin raised the risk of blood clots in the legs and lungs, stroke, heart attack and invasive breast cancer. Both raised the risk of probable dementia in women 65 and older. Do not use estrogen, with or without a progestogen, to prevent heart disease or dementia.
Tell your provider if you have or have had unusual vaginal bleeding, breast cancer or another estrogen-sensitive cancer, blood clots, a stroke or heart attack, liver problems, a bleeding or clotting disorder, or an allergy to estradiol or the patch, and if you are or may be pregnant. Tell your provider about every medication you take, and before any surgery or bed rest, since estrogen may need to stop beforehand.
Get medical help right away for chest pain, pain or swelling in your legs, sudden shortness of breath, changes in vision or speech, or a sudden severe headache. Call your provider about a new breast lump or unusual vaginal bleeding. Common side effects include headache, breast pain, irregular vaginal bleeding or spotting, stomach cramps or bloating, nausea and vomiting, hair loss, fluid retention, vaginal yeast infection, and redness or irritation where the patch sits.
Based on the current FDA prescribing information for Climara and Vivelle-Dot (estradiol transdermal system). This is not all the information about the estradiol patch. Ask your provider or pharmacist.