Evorel 2. 5, 5. 0, 7. Summary of Product Characteristics (SPC)Evorel 2. Patch, Evorel 5. 0 Patch, Evorel 7. Patch and Evorel 1. Patch. It consists of a monolayered adhesive matrix throughout which 1. The adhesive matrix is protected on the outside surface (from clothes etc) by a polyethylene teraphthalate backing foil, while the adhesive surface of the patch is covered by a polyester sheet (the release liner) which is removed before placing the patch on the body surface. This release liner has an S- shaped incision which facilitates easy removal from the patch. Estrogen patch libido. As for your question about if the Estradiol can increase your chances of breast cancer. Does estradiol 1 mg increase your sex drive? I have had the same experience with increased libido on the Estradiol patch 1mg. Find out how levels of female hormones after. Is the hormone estriol a “safer form of estrogen”? More about Menopause and Hormones. New Study: Estrogen Increases Libido in Men. Study shows that estrogen increases male libido. Houston – Baylor College of Medicine study suggests that estrogen. Evorel 25, 50, 75 & 100 patches. HRT use does not improve cognitive function. The estradiol hemihydrate of the patch is taken up through the skin as estradiol. Increase Female Libido. Taking supplements can help you to balance your hormone levels and increase your female libido. Thanda Passion Booster is an. Estradiol Transdermal Patch: learn about side. Your doctor will start you on a low dose of transdermal estradiol and may increase your dose if your symptoms are. Less estrogen to blame for older men's flab, lower libido. Men of America, are you feeling less than maximally macho? Don't blame testosterone. For initiation and continuation of treatment of menopausal symptoms, the lowest effective dose for the shortest duration (see also Section 4. Treatment of oestrogen deficiency symptoms. Therapy should be started with one Evorel 5. For maintenance therapy the lowest effective dose should be used; a maximum dose of 1. Evorel 5. 0, 7. 5, 1. Prevention of post- menopausal osteoporosis. Therapy should be started with Evorel 5. The dose may be adjusted depending on efficacy and signs of over- oestrogenisation (eg breast tenderness). ![]() Note, however, that the efficacy of Evorel 2. For maintenance therapy, the lowest effective dose should be used. A dose of 1. 00micrograms of estradiol/2. Progestogen use. For women with an intact uterus progestogen should normally be added to Evorel for the prevention of adverse endometrial effects, eg hyperplasia and cancer. The regimen may be either cyclic or continuous sequential. Only progestogens approved for addition to oestrogen treatment may be prescribed (eg oral norethisterone, 1mg/day or medroxyprogesterone acetate, 2. Unless there is a previous diagnosis of endometriosis, it is not recommended to add a progestogen in hysterectomised women. Guidance on how to start therapy: Post- menopausal women currently not on HRT may start Evorel at any time. Peri- menopausal women who are still having regular menstrual cycles and are not currently on HRT should start Evorel within 5 days of the start of bleeding. Peri- menopausal women with irregular menstrual cycles, for whom pregnancy has been excluded, can start Evorel at any time. Switching from other HRTThe switch from another oestrogen- only therapy in post- menopausal women to Evorel may occur at any time. Women on a continuous combined regimen wishing to switch from another oestrogen to Evorel may do so at any time. Women on a cyclic or continuous sequential regimen wishing to switch from a sequential combined HRT preparation to Evorel may do so at the end of a cycle of the current therapy or after a 7 day hormone free interval. Method of Administration. Evorel should be applied to the skin as soon as it is removed from the wrapper. Recommended application sites are on clean, dry, healthy, intact skin and each application should be made to a slightly different area of skin on the trunk below waistline. Evorel should not be applied on or near the breasts. Evorel should remain in place during bathing and showering. Should it fall off during bathing or showering the patient should wait until cutaneous vasodilation ceases before applying a replacement patch to avoid potential excessive absorption. Should a patch fall off at other times it should be replaced immediately. Patients can be advised to use baby oil to help remove any gum/glue which may remain on their skin after patch removal. Missed dose. If the patient forgets to change their patch, they should change it as soon as possible and apply the next one at the normal time. However, if it is almost time for the next patch, the patient should skip the missed one and go back to their regular schedule. Only one patch should be applied at a time. There is an increased likelihood of break- through bleeding and spotting when a patch is not replaced at the normal time. Children. Evorel is not indicated in children. Elderly. Data are insufficient in regard to the use of Evorel in the elderly (> 6. Route of administration. Transdermal use. In all cases, a careful appraisal of the risks and benefits should be undertaken at least annually and HRT should only be continued as long as the benefit outweighs the risk. Evidence regarding the risks associated with HRT in the treatment of premature menopause is limited. Due to the low level of absolute risk in younger women, however, the balance of benefits and risks for these women may be more favourable than in older women. Medical examination/follow- up. Before initiating or re- instituting HRT, a complete personal and family medical history should be taken. Physical (including pelvic and breast) examination should be guided by this and by the contraindications and warnings for use. During treatment, periodic check- ups are recommended of a frequency and nature adapted to the individual woman. Women should be advised what changes in their breasts should be reported to their doctor or nurse (see 'Breast cancer' below). Investigations, including mammography, should be carried out in accordance with currently accepted screening practices, modified to the clinical needs of the individual. Conditions which need supervision. If any of the following conditions are present, have occurred previously, and/or have been aggravated during pregnancy or previous hormone treatment, the patient should be closely supervised. It should be taken into account that these conditions may recur or be aggravated during treatment with Evorel, in particular: Leiomyoma (uterine fibroids) or endometriosis. A history of, or risk factors for, thrombo- embolic disorders (see below)Risk factors for oestrogen dependent tumours, eg 1st degree heredity for breast cancer. Hypertension. Liver disorders (eg liver adenoma)Diabetes mellitus with or without vascular involvement. Cholelithiasis. Migraine or (severe) headache. Systemic lupus erythematosus. A history of endometrial hyperplasia (see below)Epilepsy. Asthma. Otosclerosis. Hereditary angioedema. Mastopathy. Conditions which require monitoring while on oestrogen therapy. Cardiac or renal dysfunction should be carefully observed. The reported increase in endometrial cancer risk among oestrogen- only users varies from 2 to 1. Section 4. 8). If break- through bleeding or spotting appears after some time on therapy, or continues after treatment has been discontinued, the reason should be investigated, which may include endometrial biopsy to exclude endometrial malignancy. Therefore, the addition of a progestogen to oestrogen replacement therapy should be considered in women who have undergone hysterectomy because of endometriosis if they are known to have residual endometriosis. Breast cancer The overall evidence suggests an increased risk of breast cancer in women taking combined oestrogen- progestogen and possibly also oestrogen- only HRT, that is dependent on the duration of taking HRT. Observational studies have mostly reported a small increase in risk of having breast cancer diagnosed that is lower than that found in users of oestrogen- progestogen combinations (see Section 4. The excess risk becomes apparent within a few years of use but returns to baseline within a few (at most five) years after stopping treatment. HRT, especially oestrogen- progestogen combined treatment, increases the density of mammographic images which may adversely affect the radiological detection of breast cancer. Some other studies, including the WHI, trial suggest that the use of combined HRTs may be associated with a similar or slightly smaller risk (see Section 4. One randomised controlled trial and epidemiological studies found a two- to threefold higher risk for users compared with non- users. For non- users, it is estimated that the number of cases of VTE that will occur over a 5 year period is about 3 per 1. It is estimated that in healthy women who use combined oral HRT for 5 years, the number of additional cases of VTE over a 5 year period will be between 2 and 6 (best estimate = 4) per 1. The occurrence of such an event is more likely in the first year of HRT than later. There is no consensus about the possible role of varicose veins in VTE. HRT may add to this risk. Personal or strong family history of thrombo- embolism or recurrent spontaneous abortion should be investigated in order to exclude a thrombophilic predisposition. Until a thorough evaluation of thrombophilic factors has been made or anticoagulant treatment initiated, use of HRT in such patients should be viewed as contraindicated. Women already on anticoagulant treatment require careful consideration of the benefit- risk of use of HRT. The risk of VTE may be temporarily increased with prolonged immobilisation, major trauma or major surgery. As in all postoperative patients, scrupulous attention should be given to prophylactic measures to prevent VTE following surgery. Where prolonged immobilisation is liable to follow elective surgery, particularly abdominal or orthopaedic surgery to the lower limbs, consideration should be given to temporarily stopping HRT 4 to 6 weeks earlier, if possible. Treatment should not be restarted until the woman is completely mobilised. If VTE develops after initiating therapy, the drug should be discontinued. Patients should be told to contact their doctors immediately when they are aware of a potential thrombo- embolic symptom (eg, painful swelling of a leg, sudden pain in the chest, dyspnoea). Coronary artery disease (CAD)There is no evidence from randomised controlled trials of protection against myocardial infarction in women with or without existing CAD who received combined oestrogen- progestagen or oestrogen- only HRT. The absolute risk of CAD is strongly dependent on age. The number of extra cases of CAD due to oestrogen- progestogen use is very low in healthy women close to menopause, but will rise with more advanced age. Stroke. One large randomised clinical trial (WHI- trial) found, as a secondary outcome, an increased risk of ischaemic stroke in healthy women during treatment with continuous combined conjugated oestrogens and medroxyprogesterone acetate (MPA).
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December 2016
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