Where & How to Best Apply Estrogen Patches

Sometimes knowing how and where to stick an estrogen patch is the trickiest part.

A purple and blue gradient background with an illustration of torso wearing a bra, underwear, and estrogen patch.

Illustrations by Leo Mateus.

Estrogen comes in patches, as some of you may know. They work by delivering small, steady amounts of estradiol through the skin during the time the patch is on the body. But because estrogen patches are attached to the skin with adhesive, there are a few small challenges with keeping them attached and working.

Estrogen patches only go up to a certain dose, so, many times, increasing the dose means using additional patches (usually up to a maximum of four patches at a time). For those who are using twice per week patches, that means going through eight patches in a week, or 24 in a whole month!

Some estrogen patches are changed once a week, while others are changed twice a week. Either way, patches can still pose a few problems when it comes to adhesives. But we've got you covered with a few ways to make it a little easier.

Where to apply estrogen patches depends on what feels best to the person applying it.

Estrogen patches stick best when placed on clean, dry skin on a relatively flat area that doesn’t tend to sweat heaps or have a tons of dense hair. It’s also best to avoid any bony or bendy areas like an elbow or a knee.

Common locations to apply estrogen patches are generally:

Belly, back, or upper buttocks: on areas that can be reached, and don’t go under where a waistband might hit.

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Upper arm or thigh: but it’s important to note that with how much these limbs may move on a daily basis might lead to the patch unsticking sooner than preferable.

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There are a few things to watch out for when applying patches:

  • Avoid sensitive body areas: Sensitive spots such as the breast, chest, or genital areas should generally be avoided.
  • Avoid putting the patch on freshly shaved areas: trimming any body hair in the area for a patch to better adhere can absolutely help, but applying a patch right after shaving could cause skin irritation.
  • Don’t put the patch on anywhere irritated or healing: Make sure the skin where you place the patch is intact, and avoid placing the patch over any cuts, scrapes, burns, or sores. 
  • Patches can go on tattoos, as long as they’re healed: If there are no tattoo-free areas to put a patch, it’s okay to put one over a tattoo, as long as it’s healed.
  • Make sure multiple patches don’t overlap: If using multiple patches for a higher dose, patches can go on different spots on the body. If they are in the same area, it’s important to just make sure they aren’t overlapping. They should each have full contact with the skin so that you are able to get your full dose!

Once you have a clear spot, applying the patch is easy as!

To apply:

  1. Wash and dry hands AND the spot where the patch will be applied.
  2. Open the pouch package at the notch: cutting open with scissors may accidentally cut the patch, so it’s best to tear.
  3. Peel off the backing, stick the patch to the spot and hold firmly for 10 seconds.
  4. Keep the patch on at all times until it’s time to change it out, according to prescription instructions.

To remove:

  1. Peel the patch off gently, starting with one corner, and hold down the skin around it.
  2. If there is adhesive left, let it dry for 15 minutes, then use lotion or oil to rub any sticky residue off.
  3. Fold the patch in half to dispose of it, sticky side in, so leftover medication isn’t exposed. Throw it away immediately in a child and pet-proof container. Don’t flush the patch down the toilet.
  4. Get ready to re-apply!

Lastly, it’s important to use a new spot each time to give the last area time to breathe.

Try not to use the same spot for at least a week after taking a patch off. Some skin irritation or redness under the patch is common after removed, which is why switching spots can be helpful.

Unfortunately, estrogen patches just aren’t as sticky as we want them to be, but there are some ways to help.

Estrogen patches are waterproof, and although they can be used in the shower or during a particularly sweaty workout, they tend to stop sticking well after a few days. If a patch isn’t sticking to the body for the duration of time the prescription has stated, there are a few tips and tricks:

  • Don’t submerge underwater for a long period of time: patches can absolutely be worn in the shower, bath, or swimming, but it’s generally best to try not to keep it submerged underwater for long periods of time which can cause it to unstick.
  • Use bandaids or medical tape to help hold it down: If the patch starts to peel off or lose its stick at the edge before it’s due to be changed, then medical tape can be used to tape the patch back in place.
  • Avoid heating pads and direct sunlight: Using a heating pad over the patch or exposing the patch to direct sunlight for long periods of time can increase irritation and lead to changes in how the medicine is absorbed.

If an estrogen patch comes off completely, first try to re-apply it to a new clean, dry spot if it has some stickiness left. If it is no longer sticky, use a new patch. If you end up using more patches because they’re not sticky enough, make sure to let a provider know, as this may lead to needing a refill early.

However and wherever the patch is being applied, we can always use lab data on estrogen levels to determine how much is actually getting absorbed, and make adjustments to dosage accordingly.

For those ready to get started with FOLX for estrogen, the process begins here. For existing FOLX members with questions about their dosage, don't hesitate to message or schedule time with a clinician. And for those who’ve just got some more questions, read up on estrogen here, and feel free to reach out to us at thelibrary@folxhealth.com.