Therapeutic patches with hormones for menopause

Klimara patch for menopause: instructions and reviews

Menopause is perhaps the most unpleasant period in a woman’s life. The onset of this stage is accompanied by all sorts of deviations that have a detrimental effect on the quality of life. The most effective method of eliminating symptoms is the use of hormonal replacement drugs. Second only to pills, the menopause patch takes an honorable second place in terms of effect and popularity.

General information about the product

One of the most popular estrogen patches for menopause is Klimara, a remedy for eliminating or alleviating the symptoms of the disease. The release form of the drug is a transdermal patch that delivers the synthetic hormone estradiol into the woman’s body. In addition to its main function, the product also prevents postmenopausal osteoporosis and can be used for surgical menopause. The product containing hormones attaches to the surface of the skin and ensures a slow and important flow of the active substance into the body.

The active ingredient of Klimara completely replaces endogenous estradiol, which is naturally produced by the ovaries and has a feminizing effect. It should be remembered that the patch can remain in one place for no more than a week. After the specified period, you must select a new area of ​​the body for application.

Klimara

The estrogenic drug 17-beta-estradiol is identical to endogenous estradiol (formed in the body of women, from the first menstruation until menopause) produced by the ovaries. In the cells of the organs to which the action of hormones is directed, estrogens form a complex with specific receptors (found in various organs - in the uterus, vagina, urethra, mammary gland, liver, hypothalamus, pituitary gland), the receptor-ligand complex interacts with estrogen-effector elements genome and specific intracellular proteins that induce the synthesis of mRNA, proteins and the release of cytokines and growth factors.

Has a feminizing effect on the body. Stimulates the development of the uterus, fallopian tubes, vagina, stroma and ducts of the mammary glands, pigmentation in the area of ​​the nipples and genitals, the formation of secondary sexual characteristics of the female type, the growth and closure of the epiphyses of long tubular bones. Promotes timely endometrial rejection and regular bleeding, in high concentrations causes endometrial hyperplasia, suppresses lactation, inhibits bone resorption, stimulates the synthesis of a number of transport proteins (thyroxine-binding globulin, transcortin, transferrin, sex hormone binding protein), fibrinogen. It has a procoagulant effect, increases the synthesis of vitamin K-dependent blood coagulation factors (II, VII, IX, X) in the liver, reduces the concentration of antithrombin III.

Increases blood concentrations of T4, Fe, Cu2+, etc. Has an anti-atherosclerotic effect, increases the concentration of HDL, reduces LDL and cholesterol (TG concentration increases). Modulates the sensitivity of receptors to progesterone and sympathetic regulation of smooth muscle tone, stimulates the transition of intravascular fluid into tissues and causes compensatory retention of Na+ and water. In large doses, it prevents the degradation of endogenous catecholamines by competing for active catechol-O-methyltransferase receptors.

After menopause, only a small amount of estradiol is produced in the body (from estrone found in the liver and adipose tissue). A decrease in the concentration of estradiol produced in the ovaries is accompanied in many women by vasomotor and thermoregulatory instability (“flushes” of blood to the facial skin), sleep disorders, as well as progressive atrophy of the genitourinary system.

Osteoporosis (mainly of the spine) develops due to estrogen deficiency. It is known that oral administration of estrogens causes an increase in protein synthesis (including renin), which leads to an increase in blood pressure.

Estradiol in the form of a TTC drug is a patch attached to an area of ​​skin. The control membrane ensures a gradual and continuous release of estradiol (the active ingredient of the drug) from the reservoir with the active substance through the adhesive layer onto the skin. Due to the lack of a “first pass” effect through the liver, TTC provides high efficacy when using lower doses of the drug. TTS of the active substance of the drug delivers estradiol unchanged into the bloodstream and maintains its concentration in plasma during therapy at a constant level, adequate to the level in the early or middle phase of the follicle.

Benefits of use

In the process of treatment with hormonal drugs, the systematic entry of estrogen into the female body is extremely important. The patches perform this function just fine. Unlike many tablets, the drug has the following advantages:

• provides the opportunity to abruptly stop treatment if unwanted side effects occur;
• does not have a negative effect on the gastrointestinal tract, since the penetration of the main active substance occurs through the surface of the skin;
• compatibility with almost all medications;
• there is no likelihood of blood clots, which is explained by the low concentration of estrogen and the gentle effect of the drug;
• the entry of the active substance directly into the blood, which allows you to bypass the liver, reduce the dosage and get quick results.

Already in the first month of use, Klimara can eliminate or suppress mood and blood pressure swings, poor health and decreased libido, as well as improve memory and attention, and take body weight under control. To prescribe the dosage, you should definitely consult a doctor for a thorough diagnosis and accurate determination of hormonal levels.

Advantages

For hormone replacement therapy, not only the patch is used, but also tablets for oral administration. They have a number of contraindications and a high risk of side effects. In addition, the pills are taken at the same time every day. Skipping can cause severe hormonal imbalance. The advantages of the patch include the following:

1. Unlike tablets, it does not have a negative effect on the condition of veins and blood vessels. The likelihood of thrombosis is minimized.
2. The product is easy to use. When properly attached, it does not fall off the skin even while showering.
3. If a woman experiences intolerance to the active ingredients, it is enough to remove the patch from the skin. When taking tablets, additional measures are required to remove allergens from the body.
4. The patch does not affect the functioning of the liver; hormones enter the blood immediately. This ensures rapid relief of symptoms.
5. The patch is changed 4-7 days after wearing, and the tablets must be taken every day.
6. The drug is not prohibited from being combined with other medications. It does not affect the digestibility of the active components.

Indications and contraindications

Klimara is considered a serious drug that should be prescribed by a gynecologist. This is due to the fact that the product has quite clear indications, but there are many contraindications and side effects:

Klimara is a patch whose reviews speak for themselves. The drug has become widespread largely due to active discussion of the topic on forums. Many women are very pleased with the results of using this product as hormone replacement therapy. Klimara effectively copes with the elimination of severe negative symptoms associated with a lack of estrogen after surgery and removal of the ovaries or against the background of natural menopause. Some women also use the drug as a preventive measure for postmenopausal osteoporosis.

As for contraindications, there are quite a few of them. This includes oncological diseases and suspicions of them, sensitivity and tendency to allergies, pregnancy and lactation, deep vein thrombosis and many others. That is why doctors do not recommend self-medication, but advise that before using the drug you must consult with your specialist.

The most common side effect of the drug is a local allergic reaction in the form of slight irritation at the application site. In some cases, contact dermatitis may also occur. From the digestive system, nausea or vomiting, stomach pain and flatulence may occur.

Side effects from the genitourinary system are also common, namely bleeding or spotting, changes in the amount of secretion, pain in the chest area. Sometimes women using Klimara may experience headaches and dizziness, changes in body weight, swelling, cramps, uncontrolled depression and surges in libido.

Klimara patch, how to glue it correctly

Before menopause, the functional activity of the ovaries decreases, which suppresses the production of estrogen. To relieve the symptoms of menopause in women and replace the lack of hormones, the transdermal therapeutic system (TTS) is used - this is the general name for soft dosage forms for external use. The Klimara patch delivers synthetic estradiol to the female body through the skin. This component is identical to endogenous estradiol, which is produced by the ovarian follicular apparatus.

Who will the patch help?

The Klimara patch is prescribed to women to relieve negative symptoms due to a lack of estrogen during natural or surgical menopause. After surgery to remove the ovaries, the drug replenishes hormone deficiency. For medical reasons, it may be prescribed to prevent postmenopausal osteoporosis. Due to a lack of sex hormones, bone density decreases and the risk of fractures and sprains increases. Estradiol inhibits the process of bone tissue destruction.

The treatment regimen is prescribed by the doctor, since it is individual and depends on the health status of the individual woman.

The use of Klimara can be continuous or cyclic. The patch is changed every 7 days. With a cyclic scheme, take a week break every 3 weeks.

A fixed dose of the active substance eliminates the possibility of overdose. When used correctly, a balanced accumulation of estradiol occurs, which allows you to maintain an even hormonal balance.

How to apply, where to stick

The patch has an oval shape, size 4.5 cm x 3.3 cm. It consists of a special film with a homogeneous matrix that contains the active substance. The membrane releases the drug at an optimal rate.

The convenience of the patch lies in its ease of use. Following the instructions in the instructions, you need to remove the protective film and immediately stick it on clean, dry skin, without irritation, along the spine or on the buttocks. Some women find it more convenient to wear the applique on the forearm or shoulder blade.

It is strictly contraindicated to stick the patch near the mammary glands, directly on the breasts or in the area of ​​​​the projection of the reproductive organs, so as not to provoke a tissue response.

To fix the patch, you need to press it to the skin and hold it for about 10 seconds. To avoid discomfort, it is recommended to choose a place on the body so that there is no constant friction of the application on clothing. The patch is waterproof, it is comfortable to take a shower or bath, or swim in the pool. Visiting the bathhouse or sauna is not recommended. When exposed to hot steam, the patch comes off, so you will need to apply a new one before the 7-day period expires.

Each time the patch must be glued to a different part of the body. This improves the result of its action.

How does the Klimara patch work?

After application, estradiol penetrates the upper layers of the skin. There is a smooth and gradual increase in hormones in the blood to a stable level. The process is similar to natural estrogen growth in the follicular phase of the menstrual cycle. Transdermal penetration of the active substance instead of taking tablets avoids increased stress on the liver and kidneys.

Estradiol effectively affects estrogen-sensitive organs:

• hypothalamus;
• pituitary;
• bone tissue;
• uterus;
• urethra;
• vagina;
• mammary gland.

Hormone therapy also affects other organs. Every six months, a woman should be examined for timely detection of abnormalities in the body and adjustment of the treatment regimen.

The menopausal period significantly affects the quality of life. However, the degree of this influence depends on the general state of health, when exacerbation of chronic diseases and the emergence of new ones are possible.

The use of the patch as prescribed by a doctor, according to numerous reviews from women, solves many problems:

1. eliminates the main signs of menopausal syndrome (hot flashes, sudden changes in pressure, irritability, increased anxiety, emotional disturbances, sleep disturbances, fatigue, vaginal dryness partially or completely disappear);
2. prevents postmenopausal osteoporosis;
3. improves skin condition by increasing tissue elasticity;
4. stabilizes blood pressure.

Some women report improvements in their sex lives. Indeed, with low estradiol, libido decreases and dryness appears in the vagina. This causes discomfort during sexual intercourse. When the optimal concentration is reached, the hormone normalizes the vaginal environment.

Receiving the hormone through the skin does not stimulate weight gain and does not lead to problems with the gastrointestinal tract. Regularity is important when taking hormones. With a patch it is much easier to achieve it than with tablets, which you can forget about taking in the daily bustle.

Contraindications

Many women have a fear of hormone replacement therapy (HRT). However, hormonal fluctuations during menopause significantly affect the physiological and psychological state. Therefore, modern manufacturers offer alternative medicines.

The doctor always selects a hormonal drug individually and taking into account the ratio “possible risk - expected benefit”. There are a number of diseases and conditions in which HRT is impossible.

Absolute contraindications include:

• thromboembolism (deep vein thrombosis, pulmonary embolism);
• thromboembolic diseases (angina pectoris, myocardial infarction), including those suffered in the past;
• undiagnosed genital or uterine bleeding;
• breast cancer, high risk of its development;
• ovarian tumors;
• acute liver diseases;
• pregnancy;
• oncological diseases of the uterus and appendages (endometrial cancer, etc.);
• individual intolerance to the drug.

HRT in the above cases is not carried out even after the pathology has been eliminated.

With caution and only after a comprehensive examination of the body, the patch is prescribed to women who have a history of:

1. diabetes;
2. cardiovascular diseases;
3. bronchial asthma;
4. dysfunction of the liver, kidneys, gall bladder;
5. epilepsy;
6. migraine;
7. porphyria;
8. otosclerosis.

In addition to contraindications, the possibility of side effects should be taken into account:

• proliferation of uterine fibroids;
• possibility of breakthrough bleeding,
• spotting vaginal discharge;
• swelling, tenderness of the breast;
• nausea, vomiting, epigastric pain;
• headache, migraine, dizziness;
• allergic skin reaction;
• swelling.

In case of any negative reactions of the body to the drug, you should remove the patch and immediately consult a doctor. He will adjust the dose or completely cancel this therapy.

Each organism is individual. Some women experience menopause with mild symptoms. Others have a hard time with hot flashes, increased sweating at night, decreased activity, and impaired psychological balance. It is difficult to predict the effect of a hormonal drug and the body's reaction. New generation medications in a convenient form (patch, gel), when used correctly, make a woman’s life easier and better during the difficult period of menopause.

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Directions for use and dose

To eliminate the symptoms of menopausal syndrome, a patch with the smallest dose is used. Over time, you can give preference to a higher concentration of the active substance. After accurately selecting the dosage, to relieve the symptoms of menopause, you should use the lowest, but individually effective dose of Klimara.

To prevent osteoporosis, therapy should be started as soon as possible after the onset of menopause. In order to prevent bone loss, long-term treatment is prescribed on an individual basis.

Estrogen patch therapy is carried out in a cyclic or continuous mode, with a new patch being applied weekly. After 7 days, the old patch is removed, and a new one is attached to another area of ​​the skin. In the case of cyclic therapy, Klimara is used for 3 weeks in a row, after which a break of one week is taken.

The patch is attached to the body quite simply. After removing the protective film, the product is fixed with the adhesive side on dry, clean skin. The ideal place to place the patch would be along the spine. It is better to avoid the area of ​​the waist and buttocks, since friction may cause the plate to move or even come off completely. For reliable fixation, press the patch with your palm and hold it on top for about 10-15 seconds. If poor adhesion is detected, the plate should not be removed - it is better to press it with your fingers and hold it for a minute.

If the patient forgot to apply a new patch on time, the replacement procedure should be carried out immediately after the gap is detected. The new estrogen plate should be used as directed.

The most popular remedies for menopause

Currently, two common hormonal patches are produced: Estraderm and Klimara. The Estraderm plate is changed every 84 hours. The drug treatment regimen can be selected on an individual basis. The cost of a package of 8 patches is 1200 rubles.

Klimara is produced in Germany. In addition to estradiol, it includes acrylate copolymer, isopropyl myristate, ethyl oleate and glyceryl monolaurate. There are two dosage options on sale: 7.8 and 3.9 mg. Adhesives should be replaced every week. The approximate cost of a package of 4 adhesive plasters is 950 rubles.

Full-fledged analogues include the drug Dermestril. It is also available in the form of a patch, but is less popular. The transdermal therapeutic system can be replaced with drugs with a similar effect, but in different forms of release. Divigel and Estrogel are presented in the form of a gel for topical use. Estrofem and Octodiol tablets are indicated for oral administration.

Reviews from patients and doctors

There are a lot of reviews from doctors and patients about the Klimara patch. This is due to the popularity of the drug and its high effectiveness.

​ After the operation, the mammologist and endocrinologist unanimously prescribed the use of the patch. I have been using Klimara for almost 5 years, but at the same time I consult with my doctor at least once a year. I am very pleased with the result, there are no side effects. Moreover, the aging process has noticeably slowed down and the number of wrinkles has decreased.

At the age of 57, she underwent a serious operation, and soon menopause began. At first I took homeopathic medicines, but given my pronounced symptoms, the result was weak. The doctor prescribed Klimara, which I have been using for almost 2 years. There are practically no side effects, sometimes there is a slight discharge, but this is not scary. The only drawback is that quite often you have to undergo examination by a mammologist. Otherwise I am very pleased with the drug.

I prescribe the Klimara patch to women who experience symptoms of menopausal syndrome, as well as after a hysterectomy.

I have been working as a gynecologist for almost 10 years. I prescribe patches after surgical menopause to almost all of my patients who have no contraindications. Most often, women tolerate them better than pills, and they are a little cheaper.

Climara is an estradiol patch that is best suited for women following a hysterectomy. The plates are very convenient to use - one adhesive base is enough for exactly a week. Side effects are extremely rare, and the rules of application and care are very simple.

Instructions for use of estrogen patch during menopause

A patch for menopause can preserve the youth of the female body and fight its withering. Under the influence of age-related changes, gray hair appears, wrinkles appear, and attractiveness decreases. In addition, many organs and functions of body systems are deformed. This is exactly how menopause occurs. This is a natural process that awaits every lady. But sometimes such changes come much earlier than they should.

Physiology of the process

Menopause is a completely normal phenomenon inherent in nature itself. Appears due to a decrease in the level of female hormones, which are responsible for the proper functioning of the reproductive system. Disruptions appear in the menstrual cycle, menstrual periods come less and less often and disappear completely over time.

In some cases, women may not feel any discomfort. But this is not always the case, because every woman’s body has its own individual characteristics .

Some find it psychologically difficult to return to normal life after menopause. Even fairly young women can notice similar changes in themselves.

Menopause does not come suddenly, without warning signs. First, some changes occur in the body that reduce the concentration of the sex hormone estrogen. In this regard, disruptions in menstruation begin, which ultimately leads to its absence. For many people, the complete cessation of menstruation is a blow that leads to negative consequences.

But in most cases, the onset of menopause does not cause any discomfort. This is because this happens to adult women who already have children and even grandchildren. They have reached the heights of motherhood and no longer need reproduction.

But there is a group of ladies who perceive menopause as an insult.

They cannot come to terms with this course of affairs and are trying with all their might to fight the natural process. In this regard, nervous system disorders may occur, which are characterized by:

1. Hypertensive crises.
2. Frequent mood swings.
3. The appearance of angina pectoris.
4. Frequent insomnia.
5. Severe headaches.
6. General ailments and weakness.
7. Nausea.
8. Gaining weight.
9. Decreased sexual desire.
10. The appearance of tides.

Using the patch

Menopause can sometimes be confused with other phenomena of the reproductive system. That is why it is so important to correctly determine what exactly is happening to the body. For example, it is easy to mistake menopause for menopause because they have very similar symptoms, especially if the menopause is temporary.

It happens that menstruation does not appear in one or more cycles. This can occur due to diseases or disorders that affect hormonal levels. Typically, such deviations do not require drug interventions and return to normal on their own when estrogen concentrations are restored. In contrast, menopause will not stop without treatment.

Today, pills have been replaced by hormonal patches with estrogen for menopause, which are much more effective. When therapy with pills there were many side effects and harm to the female body. This is because the drugs were absorbed through the stomach, the hormone negatively affected the digestive system and kidneys.

This cannot be said about the patch, the components of which immediately enter the bloodstream through the skin. Due to this, there is no effect on the organs. The required dose of estrogen enters the blood regularly. It is very small, so it cannot harm a person.

The product is very practical to use. It can also be placed on any area of ​​the skin. The patch does not interfere with your normal lifestyle and takes up very little space.

Klimara - Reviews of Klimara

Klimara is a drug based on sex hormones. It contains synthetic estradiol. It is the lack of this hormone during menopause that leads to a noticeable deterioration in the condition of women - the so-called menopausal syndrome. The health of the cardiovascular system suffers, metabolism is disrupted, leading to brittle bones and loss of tissue elasticity. Medicines that add the required dosages of hormones to the body are involved in replacement therapy. This treatment is intended to prevent the development of age-related pathologies in women, as well as to reduce the intensity of already manifested symptoms. However, the prescription of Klimara, like other estradiol drugs, should be accompanied by monitoring the condition of the endometrium of the uterus. According to the standard, such therapy should also include the introduction of another hormone - gestagen, which will prevent the pathological growth of the internal mucous layer of the uterine cavity.

Klimara is used for:

The release form of Klimara is a patch, which is called a transdermal system. These patches contain a certain dose of the active substance, which gradually penetrates into the patient’s blood. The duration of use of one transdermal therapeutic system is a week. The instructions for the drug Klimara indicate that there are several schemes for its use. Or the patches are glued for a long time, without interruptions. Or use Klimara for three weeks in a row followed by a week break.

The patch should be applied to an undamaged (and not irritated), clean, dry area of ​​skin, where it will not be constantly subject to friction with clothing (for example, in the waist area). Climar should not be used in the breast area. Correctly applied to the skin, the transdermal system allows you to shower and bathe. However, you should not wash with too much hot water or take a steam bath. After removing one patch, the next one should be applied to another area of ​​the skin. If for some reason the transdermal system comes off before the expiration of seven days, a new patch must be used in its place before the expiration of the week. Then it is removed (even if it only lasted a day, two, three, etc.) and thrown away, and the next patch is glued to a new place.

Klimara is contraindicated for:

• Malignant neoplasms, even suspected ones, including suspected breast cancer;
• Diseases associated with increased blood clotting - thrombosis, thromboembolism;
• Liver tumors;
• Vaginal bleeding of unknown etiology;
• Pregnancy, breastfeeding;

Side effects and overdose of Klimara

Most often, when using a transdermal therapeutic system, patients experience skin irritation at the site of application. The hormonal component of Climar may be associated with the appearance of discharge - from breakthrough to spotting, swelling and tenderness of the mammary glands, and the growth of fibroids. From the digestive system, a feeling of nausea, liver dysfunction, and flatulence are possible. Some patients complain of headaches, low mood, and dizziness. In addition, allergic reactions, skin reactions, swelling, weight gain, and so on are sometimes observed.

An overdose when using Klimar is very unlikely. Its symptoms may include nausea and stomach pain. Therapy is symptomatic.

Reviews about Klimara

Women who write reviews about Klimara and other hormone replacement therapy drugs prefer gels rather than patches. Here's what they write about attempts to use transdermal systems:

— I sweat often now. And because of this, the patch comes off. It seems that they wanted to make a convenient thing, but using gel is more convenient.

— My choice is Divigel. But I can’t take Klimara – it gives me rashes and itching.

There are stories of more severe reactions to this drug. For example:

— After sticking the first patch, I felt worse - I felt nauseous, dizzy, and my liver began to ache. I had to give up this treatment.

Overall, it’s worth trying Klimara to find out exactly how your body reacts to this drug. You may find applying a patch once a week less burdensome than applying gels daily. However, be prepared for the fact that this form of replacement therapy will not suit you. Then the doctor must prescribe you medications in a different form.

Overall rating: 3.9 out of 5

zhivizdorovim.ru

Best views

Nowadays pharmacies offer a large number of products from different manufacturers. They help relieve women from hot flashes, irritability and excessive sweating. Among them are the most popular ones, which have good reviews from doctors and patients.

The German patch Klimara is presented in two versions: 12.5 cm and 25 cm. They are absolutely identical in action, but the concentration is different depending on the size. In a small patch the hormone is at a level of 0.05 mg, while in a large patch it is 0.1 mg. The products come with detailed instructions for using Klimara, the price and reviews of which are encouraging.

One patch can be worn for 7 days, after which it loses its strength. After it you can attach a new one. Severe manifestation of symptoms may be an indication for using the patch in a course. In such cases, doctors usually prescribe taking the drug every month for 2 weeks in a row. A package of Klimara patches can be purchased at any pharmacy. Its price starts from 900 rubles. The package contains 4 patches. There are cheaper analogues.

There is another famous remedy - Estraderm. According to the instructions, it is recommended to use the drug within 4 days. If the symptoms are too severe, the remedy is used without interruption until the very end of treatment. If, on the contrary, it is weak, then twice a week. Estraderm is a safe drug that has been tested and studied by specialists.

Instructions for use

Klimara is produced in the form of a patch measuring 4.5*3.3 cm. Under a special film there is an active substance, which begins to act upon contact with the skin. The package contains 4 patches.

Continuous use of the drug, cyclic, is allowed. Depends on the individual characteristics of the body, the reasons for therapy. After removal of the ovaries, Klimara is used for 2–3 weeks before surgery. To eliminate the symptoms of menopause, 2 schemes are shown - continuous, the patch is applied every week, cyclic - after 3 weeks they take a break.

The method of application is quite simple. It is necessary to remove the strip from the bag, stick it on clean, dry skin along the spine, on the buttocks. It is not allowed to stick near the mammary glands. After a week, remove it and stick a new one in another place. For better fixation, press down with your fingers and hold for about 10 seconds. You should not glue in places where clothes constantly rub. For example, at the waist. You can take a shower or bath with the patch. It is not recommended to visit the sauna or bathhouse. Hot water and constant exposure to steam promote peeling.

Since its introduction, the drug has aroused particular interest among women. It’s very easy to use, you don’t need to carry out the procedure every day, you won’t miss a pill. The dose is standardized, overdose is excluded. Thanks to the Klimar patch, it is possible to reduce the symptoms of menopause, improve the condition of the genital organs, and improve the quality of sexual life.

Instructions for use

To use the product, simply remove the protective film and stick the product to a convenient area of ​​the skin. The main thing in this procedure is to thoroughly clean and dry the surface of the body. The best location is considered to be the buttocks and lower back. It is forbidden to place the patch in the chest area and lower abdomen.

It is not necessary to use the drug for a course. It can be used for a short time. It is correct to start the course of treatment with the smallest dosage. This way you can understand how the body reacts to this product. If allergies do not occur and there are no unpleasant changes in your health, you can gradually increase the dose.

When you need to remove the product immediately:

1. Redness of the skin appeared.
2. Swelling of the skin under the patch.
3. My chest hurts and itches.

Frequent headaches.

• Appearance of weakness in the body.
• Dizziness.
• Nausea.
• Changes in the volume of cervical vaginal discharge.
• Fast weight gain.

Klimara - official instructions for use, analogues

Analogs, articles Comments

INSTRUCTIONS for medical use of the drug

Trade name: Klimara

Estradiol

transdermal therapeutic system,

The Klimar transdermal system, releasing 50 mcg per day for 7 days, is a 12.5 cm2 patch containing 3.8 mg estradiol (equivalent to 3.9 mg estradiol hemihydrate) in an acrylic adhesive matrix. The Klimar transdermal system, releasing 100 mcg per day for 7 days, is a 25.0 cm2 patch containing 7.6 mg estradiol (equivalent to 7.8 mg estradiol hemihydrate) in an acrylic adhesive matrix.

Excipients: For a dosage of 3.9 mg/12.5 cm 2: Poly (acrylamide-c-isooctyl acrylate-c-vinyl acetate) (5:75:20) - 99.90 mg, ethyl oleate - 19.25 mg, isopropyl myristate - 9.65 mg, glycerol monododecanoate - 4.80 mg, polyethylene film (LDPE) - 12.5 cm2

For a dosage of 7.8 mg/25.0 cm2: Poly (acrylamide-c-isooctyl acrylate-c-vinyl acetate) (5:75:20) - 99.90 mg, ethyl oleate - 19.25 mg, isopropyl myristate - 9.65 mg, glycerol monododecanoate - 4.80 mg, polyethylene film (LDPE) - 25.0 cm2

Description Oval-shaped patch (about 4.5 cm by 3.3 cm, corresponding to 12.5 cm2), consisting of a transparent carrier film with a transparent homogeneous matrix containing the active substance.

An oval-shaped patch (about 6.30 cm by 4.7 cm, corresponding to 25 cm2), consisting of a transparent carrier film with a transparent homogeneous matrix containing the active substance.

Pharmacotherapeutic groupEstrogen

ATX code: G03CA03

Pharmacological properties Pharmacodynamics Decreased ovarian function, accompanied by a decrease in estrogen production, leads to menopausal syndrome, characterized by vasomotor-vegetative and organic symptoms.

Hormone replacement therapy (HRT) is aimed at reducing these symptoms. Of all physiological estrogens, estradiol is the most active, having the greatest affinity for estrogen receptors.

17-beta-estradiol is identical to endogenous estradiol produced by the ovaries.

Has a feminizing effect on the body. Stimulates the development of the uterus, fallopian tubes, vagina, stroma and ducts of the mammary glands, pigmentation in the area of ​​the nipples and genitals, the formation of secondary sexual characteristics of the female type. Inhibits bone resorption, stimulates the synthesis of a number of transport proteins (thyroxine-binding globulin, transcortin, transferrin, sex hormone-binding globulin), fibrinogen. Increases blood concentrations of thyroxine, iron, copper, etc. Modulates progesterone receptors and sympathetic regulation of smooth muscle tone, stimulates the transition of intravascular fluid into tissues and causes compensatory retention of sodium and water. In large doses, it prevents the degradation of endogenous catecholamines by competing for active catechol-O-methyltransferase receptors.

Estradiol transdermal therapeutic system (TTS) is a patch that is attached to an area of ​​skin. The control membrane ensures a gradual and continuous release of estradiol from the active substance reservoir through the adhesive layer onto the skin. Due to the absence of a “first pass” effect through the liver, TTC provides high efficiency when using lower doses of the drug. TTS delivers estradiol unchanged into the bloodstream and maintains its plasma concentration during therapy at a constant level, adequate to the level in the early or mid-follicular phase.

Regardless of the route of administration, the doses of estrogen required to reduce menopausal complaints have a dose-dependent stimulatory effect on endometrial mitosis and proliferation. Estrogen monotherapy increases the incidence of endometrial hyperplasia and thereby the risk of endometrial carcinoma. In order to prevent endometrial hyperplasia in women with a preserved uterus, sequential administration of gestagen is recommended for 10-14 days.

Pharmacokinetics After skin application of Klimara, estradiol is well absorbed through the skin. The average absorption rate is 50 mcg/day and 100 mcg/day, respectively.

Weekly application of Klimara is comparable to a continuous low-dose intravenous infusion aimed at creating an even, stable, plateau-like level of serum estradiol similar to the level that is created during the early/mid follicular phase of the reproductive period of life. Transdermal administration avoids the high fluctuations in serum estradiol and its metabolites as observed after oral estradiol replacement therapy and, accordingly, avoids loading the liver with large amounts of estradiol and its metabolites due to the high first-pass metabolism (“first pass effect”) after oral administration. Thus, after transdermal administration of estradiol, there is no effect on protein synthesis in the liver.

The absolute value of serum estradiol levels is directly proportional to the area of ​​the patch. The average steady-state serum estradiol concentration is approximately 35 pg/ml (12.5 cm2 patch) and 70 pg/ml (25 cm2 patch).

After application of the TTC systems 50 mcg (patch, area 12.5 cm2) and 100 mcg (patch, area 25 cm2), the physiological concentration of estradiol in the blood serum is achieved within 2-4 hours. 24 hours after removal of the system, the concentration of estradiol in plasma decreases to its original value. The content of estradiol metabolites in urine on day 2 after removal of the system reaches the same values ​​that were measured before application.

About 61% of estradiol binds nonspecifically to serum albumin and about 37% specifically to sex steroid-binding globulin.

Following transdermal administration, the conversion of estradiol to estrone and conjugates remains within the physiological ranges observed during the early follicular phase of reproductive life, with an estradiol/estrone serum level ratio of approximately 1:1. High levels of estrone as a result of intensive metabolism during “first pass” through the liver during oral HRT with estradiol, reflected by an estradiol/estrone ratio lower than 0.1, are not observed.

The biotransformation of transdermally administered estradiol is similar to that of endogenous hormones: estradiol is primarily metabolized in the liver, but also extrahepatically, for example, in the intestine, kidney, skeletal muscle and target organs. These processes include the formation of estrone, estriol, catechol estrogens and their conjugates - sulfates and glucuronides, which have significantly less estrogenic properties or even do not have them.

Some of the estradiol metabolites are excreted in the bile and undergo the so-called enterohepatic circulation. Ultimately, estradiol metabolites are mainly excreted as sulfates and glucuronides in the urine.

Metabolism and elimination when using TTC corresponds to the metabolism and elimination of natural estrogens.

With repeated weekly application of the patch, no accumulation of either estradiol or estrone is observed. Accordingly, the equilibrium serum level of both hormones corresponds to the level observed after a single application.

Indications for use

• Hormone replacement therapy (HRT) to treat symptoms of estrogen deficiency due to natural menopause or surgical removal of the ovaries.
• Prevention of postmenopausal osteoporosis.

Contraindications Hormone replacement therapy (HRT) with Climara should not be started if any of the conditions or diseases listed below are present. If any of these occur while using HRT, stop taking the drug and consult your doctor.

• Pregnancy or breastfeeding period.
• Bleeding from the genital tract, the cause of which is unclear.
• Breast cancer or suspicion of it.
• Hormone-dependent malignant neoplasms or precancerous conditions, or suspicion of them.
• Benign or malignant liver tumor currently or in history.
• Exacerbation of deep vein thrombosis, thromboembolic diseases currently or in history.
• Hypersensitivity to the components of Klimara.
• Acute arterial thrombosis or thromboembolism (such as myocardial infarction, stroke).

Use with caution - arterial hypertension, liver dysfunction, endometriosis, uterine fibroids, diabetes mellitus (see "Special Instructions").

Method of administration and dosage - Treatment of symptoms of menopausal syndrome

Treatment begins with the smallest dose of the Klimara® patch. If necessary, you can use a higher dose patch. Once the dose is adjusted, the lowest effective patch dose should be used to relieve symptoms.

— Prevention of osteoporosis Treatment to prevent postmenopausal bone loss should be started immediately after menopause. Long-term treatment based on an individual approach is recommended.

Treatment should be carried out either continuously or cyclically. When switching from long-term continuous or cyclic therapy: treatment should begin the day after the end of the previous treatment regimen.

Estrogen-only therapy is used if a woman has had a hysterectomy. In women with an intact uterus, progestogen should be added to Climara treatment for 10-14 days each month. When using patches that released more than 50 mcg of hormone/day, no protective effect on the endometrium was detected with the addition of progestogens.

The patch should be permanently applied weekly, each used patch should be removed after 7 days, after which a fresh patch should be applied to another location.

Patches may also be recommended for cyclic treatment. In this case, the patch is applied weekly for 3 consecutive weeks, followed by a 7-day patch-free interval until the next course of treatment.

Menstrual-like bleeding normally develops 2-3 days after stopping the use of gestagens.

Method of attaching the patch After removing the protective film, the Klimara® patch is attached with the adhesive side to a clean, dry area of ​​skin along the spine or to the buttocks. Klimara® should not be attached in or near the mammary glands. The area chosen for fixing the patch should not be greasy, damaged or irritated; it is also necessary to avoid the waist area, since rubbing with tight clothing may cause the patch to come off. Avoid applying the patch to areas of the skin where the patch could become dislodged when sitting.

The patch must be attached immediately after opening the package and removing the protective film. The patch should be firmly pressed with the palm of your hand to the place of fixation for approximately 10 seconds. You need to make sure there is good contact with the skin, especially around the edges. If the patch does not fit tightly, you should press on it for better adhesion.

The application site should be changed with an interval of at least one week between applications.

If the patch is attached correctly, the patient can bathe or shower as usual. However, the patch may come off from the skin when exposed to very hot water or in a sauna.

Untimely replacement or loss of the patch: - If the patch comes off before the end of the 7-day course of treatment, you can try to glue it again. If necessary, you can apply a new patch for the remaining days of the 7-day application interval. — If the patient forgot to change the patch on time, the replacement should be made as soon as possible after the fact of omission is established. A new patch should be used after the normal 7-day treatment period has ended.

Side effects The table below shows information on the frequency of adverse events when using the drug Klimara® (MedDRA - Medical Dictionary of Regulatory Activity). The information is based on clinical trial data.

The most common adverse reactions reported during clinical trials were skin irritation at the application site and breast pain (>10%). Local symptoms at the application site are generally mild and include redness, itching, burning and vesicular formation.

Systemic organ class

Often ≥/100 and 1 medi.ru

Reviews from women

I have been taking the drug continuously for a month now. After 7 days, I noticed improvements in my health. Hormonal levels are gradually returning to normal. The apathy and anxiety disappeared, and normal appetite finally returned. With the advent of menopause, I lost a lot of weight, but everything is gradually returning to normal. The patch does not interfere with leading an active lifestyle. I play sports with it and take a bath without any difficulty. Just don’t wash it under very hot water, otherwise it will come off.

The product is, of course, good, but can only be used under the supervision of a specialist. This is the only way it works properly, without side effects or any problems. Before use, I was examined and donated blood. Now the hot flashes are gone from my life, there is no severe sweating and nausea. I place the product on my thigh and forget about it for 7 days. During the whole time I was taking it, it never came off, although I really like going to the sauna.

I was so worried that I would gain a lot of weight when my doctor prescribed the Klimar patch. But fortunately, everything worked out fine. I have been using this drug for the seventh month and have not gained a single extra kilogram. The patch cannot be compared with tablets, because it is more convenient to use and more effective. Very simple, just glue it on and that’s it! It doesn’t come off when washing and swimming in the pool, just don’t rub it with a washcloth.

Hormonal patches for menopause

Every woman has a time when menopause comes to her with all its painful symptoms. Most ladies of Balzac's age are confident that you can get rid of its symptoms with anything, but not with hormonal drugs.

It is believed that such therapy entails a large number of negative side effects and consequences. However, modern pharmacology can offer very effective hormonal patches for menopause.

This is also a hormonal drug; it contains an active component that is absorbed through the skin, bypasses the liver and other important organs, and therefore practically does not cause them any harm.

Benefits of hormonal patches during menopause

The main advantages of such patches in the treatment of menopause are as follows:

1. When treating the painful symptoms of menopause, regular use of medications is very important. Skipping a dose of medication can have a negative impact on a woman’s health.

As is known, during menopause the patient’s memory and attention decrease, which means that the likelihood that the next drug may be taken in violation of the deadlines increases significantly.

The good thing about a hormonal menopause patch is that once you use it, you can forget about it for a long time. Those. When taking this drug, the risk of violating the regime of its use is practically eliminated.

2. The hormone contained in the patch is introduced into the body gradually. This eliminates the possibility of its high concentration in the female body. Hormonal patches for menopause are much gentler than many medications.

3. Hormones from the patch enter directly into the capillaries through the skin, which means that with its help you can get rid of hot flashes and pressure surges as quickly as possible, bypassing the liver and kidneys.

4. The menopause patch does not interact with other medications that a woman takes during menopause. This fact once again protects it from negative side effects.

5. And the most important advantage of the patch during menopause is its absolute safety. It has no effect on the liver, blood vessels and other organs and systems of the female body.

6. Therapeutic patches for menopause are easy to use, they do not bother a woman in her daily life, but are very effective and eliminate painful symptoms as quickly as possible.

7. If side effects suddenly appear, then simply remove the patch, and the negative symptoms will immediately disappear. Gastric lavage or activated charcoal are not required.

Description of the patch.

It is an estrogenic substance. This is a medical patch containing 17-estradiol.

This substance is similar to endogenous estradiol, which is produced by women's ovaries. A decrease in ovarian function is accompanied by a decrease in estrogen production, which can lead to the development of premature menopause syndrome. Climara affects the body in a hormonal manner with the beneficial purpose of reducing these symptoms. The receptor complex moves toward the middle, where it binds to DNA at a specific sequence, increasing transcription of the regulated gene. The entire protein induced by estrogen is unknown.

How does a hormonal patch work during menopause?

The patch is glued to the skin, and the estradiol hormones on its surface enter the female body through the skin through capillaries. As a result, a constant, stable level of hormones in the blood is created there.

A patch with female hormones during menopause eliminates overdose, thanks to the peculiarities of the introduction of its active component. The dose entering the blood depends only on the area of ​​the patch in contact with the skin.

The gynecologist determines which patch and what area the patient needs in each specific case. Do not try to do this yourself, do not self-medicate under any circumstances.

Remember that all hormonal and non-hormonal patches can be used only after undergoing all necessary examinations by a gynecologist, incl. after a blood test for hormone levels.

Mode of application

The medicine will be effective only if used correctly. The patch is attached with the adhesive side, having first removed the protective film. There should be no wounds or damage on the skin surface. The patch is placed on the buttocks or in the spine area. In addition, you can fix it on your hips or forearms. After attaching, you must press firmly on its surface for 10 seconds. It is important to ensure that the patch is properly attached to the edges.

Names of patches for menopause

When menopause occurs, women use a huge number of medications, some of which are not recognized by modern medicine. This also applies to hormonal patches. Read the instructions for their use carefully.

Estraderm

This is a wonderful patch for hot flashes during menopause, which is glued to the skin and does not come off for 4 days. During this time, all of its active substance is gradually absorbed into the female body through capillaries.

If hot flashes characteristic of menopause do not stop, you can repeat and apply a new patch for another 4 days. If painful symptoms continue, it is recommended to do this for a long time.

Klimara patch

This patch helps to quickly get rid of hot flashes that plague women during menopause. It comes in different sizes and dosages and is valid for 7 days. This is quite enough to relieve the symptoms of menopause.

If a woman has severe, repeated hot flashes, then after using one Klimar patch, you can then stick on the next one and continue to do this until the condition is completely normalized.

Chinese patches

You can buy patches made in China at the pharmacy. They are not hormonal, but have natural active substances - extracts of medicinal plants and phytoestrogens.

These patches for menopause are quite effective in helping to reduce the number of hot flashes during menopause and normalize the level of sex hormones in the blood. At the same time, they act gently and have virtually no negative side effects.

Features of using the Klimara patch during menopause

Modern medicine offers women many ways to combat the symptoms of menopause. One of these remedies is a patch called Klimara, which helps make it easier to endure the onset of menopause, as well as prevent some diseases associated with a lack of female sex hormones.

This drug is selected individually by the attending physician based on the patient’s complaints and her health characteristics. According to reviews, it is an effective means of HRT, with the help of which it is possible to significantly reduce the manifestation of menopause, improve the general condition of a woman and maintain health during menopause.

How does Klimara work?

The Klimara patch is prescribed to women with low levels of estrogen in the body. This may be a consequence of menopause or removal of the ovaries. In addition, the drug acts as an excellent preventive drug for osteoporosis. It is prescribed for symptoms of early, natural or surgical menopause.

The skin absorbs estradiol well, after which the active substance enters the blood. At the same time, the level of hormones does not increase sharply, and a gradual improvement in hormonal levels does not cause discomfort to the woman, allowing the body to gradually get used to the positive changes.

This method of obtaining hormones for a woman does not burden the liver and kidneys. And the gradual action of estradiol blocks possible fluctuations in the hormone. Therefore, hormonal levels remain at a constant level without sudden changes. As for the removal of the drug from the body, it is excreted along with urine and bile.

It is important to note that the patch selectively affects the functioning of the following organs:

• uterus,
• ovaries,
• urethra,
• pituitary,
• hypothalamus,
• mammary gland,
• bone,
• vagina.

It is worth remembering that prolonged use of the patch without breaks can negatively affect other organs. Therefore, it is so important for a woman to undergo a systematic examination in the hospital (at least once every six months).

What symptoms of menopause does the drug eliminate?

This patch during menopause provides the body with a specific dose of female sex hormone. Thanks to this, you can reduce or completely get rid of the following symptoms of menopause:

If you read reviews from doctors and patients, the drug also helps remove toxins and waste from the body, lower cholesterol and improve metabolic processes. In addition, the product works effectively in the first stages of osteoporosis.

Composition of the drug

Klimara is considered one of the best patches for menopause. It contains the main active substance – Estradiol (in the form of hemihydrate). In addition, the drug contains:

• isopropyl myristate,
• ethyl oleate,
• glyceryl monolaurate,
• acrylate copolymer.

All data is displayed in the patch instructions. There are several dosages of the drug, depending on the content of Estradiol. It can be 3.9 mg or 7.8 mg.

You need to remember that the dosage of the drug is determined by the doctor. In addition, the product is sold in pharmacies only with a doctor's prescription.

Release form and method of application

The product is available in the form of a patch, which has dimensions of 35*33 mm. The patch itself is protected by a special film, under which the active substance is located. The package contains four patches, which begin to affect the body after contact with the skin.

The manufacturer of Klimara is a German pharmaceutical company.

As for the use of the product, it can be continuous or cyclic. This factor is determined by the individual characteristics of the female body and the reason why the doctor prescribes hormone replacement therapy:

1. Removal of ovaries. Before the operation, Klimara is used for two to three weeks. After removal of the ovaries, the doctor determines the timing.
2. Treatment of menopause symptoms. Two schemes: continuous use of one patch per week or cyclic use - break after 21 days.
3. At the first signs of osteoporosis. Continuous or cyclic treatment based on an individual approach.

How to glue the patch correctly?

First you need to remove the protective film, and then stick the patch on a clean and dry area of ​​skin in the area of ​​the buttocks or along the lumbar spine. It is strictly prohibited to use the patch near the breast. In addition, it is worth excluding areas where clothing constantly rubs against the skin.

You can take a shower and bath with the patch, but you should avoid going to the bathhouse or sauna. If the patch comes off, it is replaced with a new one, but is not kept in place for more than the time remaining from the previous sticking.

Klimara and its instructions, despite the ease of use, require increased care. The instructions contain a number of requirements that must be followed. This patient’s approach to treatment is the key to protection from side effects and overdose.

Contraindications and possible side effects

Like any hormonal drug, Klimara has contraindications that make the use of the drug impossible. All contraindications should be familiarized with before starting hormone replacement therapy:

• acute blockage of a blood vessel (thromboembolism);
• thrombosis;
• vaginal bleeding;
• mammary cancer;
• suspicions of various pathologies;
• individual intolerance to the drug.

There are also situations when the menopause patch should be used especially carefully and under the strict supervision of a doctor:

• problems with the heart and blood vessels;
• diabetes;
• endometrial oncology;
• liver and kidney problems;
• gallbladder diseases;
• systematic headaches;
• otosclerosis.

Important! If during use of the patch the condition worsens or health problems arise, then HRT is completely canceled or the attending physician adjusts the dosage.

The following side effects may occur when using this hormonal drug:

• development of a benign tumor;
• constant spotting vaginal discharge;
• chest pain;
• nausea and vomiting;
• stomach pain;
• general weakness;
• loss of balance and headaches;
• the appearance of excess weight;
• blurred vision;
• nervous disorders;
• swelling.

Many reviews indicate rare side effects when the correct dosage and method of use are observed.

Special instructions for using the patch

Before starting hormone replacement therapy and during it, you should visit not only your gynecologist, but also undergo a general examination. Worth checking:

• pelvic organs;
• mammary gland;
• blood;
• abdominal cavity;
• pressure.

It is imperative to check hormone levels so that the doctor can correctly adjust the treatment and select the appropriate medications. In addition, before starting hormone replacement therapy, you should stop taking hormonal contraceptives.

Benefits of using the patch

The hormonal patch has a whole list of advantages over other hormonal agents:

1. Smooth entry of estradiol into the blood. Every day, no more than 50 mcg of the hormone is transferred from the patch to the body at a stable rate. That is why overdose, when used correctly, is completely excluded.
2. Fewer side effects. While oral hormonal drugs can cause thrombosis, patches do not cause such a disease.
3. Direct entry into the blood. Estradiol enters the blood through the skin without affecting the stomach, liver and other organs that may be affected by HRT.
4. Possibility to combine with other drugs. In this case, a woman can take several medications at once, but only after being prescribed by the attending physician.
5. Quick reaction to allergies. If the patch causes allergic reactions, then it is enough to remove it, and the substances stop entering the blood.
6. Ease of use. Quite easy to use compared to tablets (no need to take every day).
7. Affordable prices. Transdermal drugs cannot be called expensive, since they are not very different from oral drugs.

Analogues of Klimara

If a woman cannot use this remedy, then the doctor may prescribe other drugs that are similar in composition:

• Divigel.
• Estrofem.
• Estrimax.
• Dermestril.
• Octodiol.
• Estrogel.
• Menorest.

Analogs are available in the form of tablets, gel or patch. They are similar in action to Klimara, but a woman cannot select analogues on her own. To do this, you need to see a doctor and undergo appropriate diagnostics.

The menopause patch Klimara has become a very popular hormonal remedy among women. It is very easy to use, and you do not need to carry out the procedure every day. In addition, it ensures a gradual intake of the hormone into the body, eliminating overdose.

A patch called Klimara is an effective assistant in the fight against the symptoms of menopause, which can also improve a woman’s health and sex life.

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How is a hormonal patch used during menopause?

In order for the patch to have the most positive effect on the female body, you should know how it should be applied correctly. Then it will not only be useful, but also as safe as possible.

The patch will be most effective if it is stuck in the right place. The best choice is the back and buttocks. You should not stick it on the mammary glands and the skin around the genital and reproductive organs.

Remember that hormones, first of all, penetrate not into the blood capillaries, but into the surrounding tissues. And the tissues can give a negative response to female sex hormones from the patch.

Before gluing the plate, several simple requirements :

1. The skin should be washed thoroughly with soap and then dried thoroughly. There should be no creams on its surface under the patch.
2. The protective film is removed from the patch immediately before it is applied. It should be applied to the skin carefully, evenly and without wrinkles.
3. First, it is recommended to try a patch with a minimum dose of hormones, then observe the body’s reaction to it, and if necessary, increase the dose.
4. Treatment should continue only as long as it takes to eliminate painful symptoms.

If negative consequences occur, you should immediately remove the patch and contact your treating gynecologist.

If itching and redness of the skin under the patch immediately appear, headaches, nausea and vomiting begin to bother you, most often it is enough to simply remove it.

If all the requirements are met, a woman during menopause can quite easily get rid of hot flashes, surges in blood pressure, insomnia, attacks of aggression and mood swings.

Contraindications

Despite the advantages of the drug, not everyone is allowed to use it. You must first familiarize yourself with the list of contraindications. It is recommended to undergo not only a gynecological, but also a general medical examination. Mandatory procedures include a general blood test, ultrasound monitoring of the mammary glands and pelvis, as well as ultrasound of the abdominal organs. In addition, it is necessary to take a hormone test. If you have heart disease, diabetes, migraines and vascular pathologies, you need to be careful when using the patch. It is strictly forbidden to use it for the following pathologies:

• blockage of blood vessels;
• metrorrhagia;
• allergic reaction to components;
• endometriosis;
• myoma;
• breast oncology.

In some cases, uterine bleeding that is not associated with menstruation occurs during hormone replacement therapy. They indicate that the drug is not suitable for a woman. In this case, you should consult a doctor to select an alternative replacement. It is recommended to stop using the drug.