What is Vivelle Dot (called Estradot in Canada)?

Vivelle Dot (called Estradot in Canada) is a prescription estrogen replacement therapy, administered as a transdermal patch, that contains Estradiol, a type of estrogen. You might be familiar with the term Estradiol because Ethinyl Estradiol is often used in hormonal birth control. Estradiol should not be confused with medications that contain conjugated estrogens (such as Premarin); these include a mixture of estrogens as opposed to one specific type.

Synthetic Estradiol functions like the primary type of estrogen usually produced by a person's ovaries. This estrogen is essential for a number of bodily functions, but its supply may decrease during menopause or because of other hormonal issues. When this happens, several negative bodily effects-including diminished bone density or vaginal dryness-can occur. Hormone replacement therapy via supplemental Estradiol may provide one option for managing these adverse effects.

The transdermal administration of this medication means the patch is applied directly to the skin. It then releases Estradiol into and through the skin so it can circulate through the body. Once it enters the body, Estradiol helps increase estrogen levels and maintain the bodily functions that require estrogen, including protein synthesis, DNA and RNA synthesis, healthy pituitary function, and healthy bone maintenance. In some cases, Estradiol may be administered as a spray or topical Estradiol in gel form. Estradiol vaginal options include tablets or rings that are inserted directly into the vagina.

An Estradiol patch is prescribed for a number of conditions, many of which relate to menopause. These include hot flashes, night sweats, vaginal dryness, and/or postmenopausal osteoporosis. Estradiol may also be used to treat people whose estrogen levels are low for a reason other than menopause or occasionally for other purposes as determined by a medical professional.

Anyone who is dealing with any of the conditions listed here or who is at risk for developing postmenopausal osteoporosis might be prescribed hormone therapy in the form of Vivelle Dot.

Conditions treated by Vivelle Dot

As noted above, Vivelle Dot may be prescribed for a number of conditions, including menopausal symptoms (such as hot flashes, night sweats, and vaginal dryness); vulvar or vaginal atrophy stemming from menopause; the prevention of postmenopausal osteoporosis; and the management of symptoms associated with low estrogen levels that may not be attributable to menopause.

As you can see, most of the symptoms that might warrant a Vivelle Dot prescription relate in some way to menopause. During menopause, a person's ovaries begin to produce less of the hormones estrogen and progesterone. This can result in a number of physiological changes, some of which may not be pleasant. Vivelle Dot is meant to assist people who are struggling with symptoms that might otherwise interfere with their quality of life.

In some cases, Vivelle Dot may also be prescribed to help prevent osteoporosis. Women may be at an increased risk of developing osteoporosis after menopause because estrogen helps maintain bone health. (The same is true for anyone with lower-than-normal estrogen levels.) Decreased estrogen levels may have a negative effect on bone strength and density.

What to know before taking Vivelle Dot

Prior to using Vivelle Dot, be aware of the following:

• Talk with your doctor about any medical issues you might be dealing with or any other medications or herbal supplements you take. Certain medical conditions, medications, and supplements may interact with Vivelle Dot and increase the risk of developing side effects.
• Be aware that long-term use of estrogen hormones can carry significant health risks. For this reason, it's important to use Vivelle Dot only as directed by your doctor and report any unusual side effects to your doctor immediately.
• It's generally not advisable to use Vivelle Dot if you're breastfeeding, as estrogen may be passed through breast milk. Additionally, people who are pregnant or attempting to become pregnant should not use Vivelle Dot.
• It's important to see your doctor regularly while using Vivelle Dot. They'll assist you in conducting regular breast and pelvic exams and can help you course-correct if you're experiencing negative side effects.
• Always wash your hands thoroughly prior to applying a Vivelle Dot patch. Do not apply the patch on broken skin or on or near the breasts, eyes, mouth, nose, or vagina.
• It's okay to expose an Estradot patch to water such as in the bath, shower, or pool. If the patch falls off, simply reapply it. (If it doesn't stick, apply a new patch and then resume your usual application schedule.)
• If you're going to have surgery while using Vivelle Dot, make sure to inform your medical team. You may need to stop using the patch for a little while before and after the surgery.
• Avoid smoking while using Estradot patches, as this can greatly increase the risk of adverse effects such as blood clots, strokes, or heart attacks.
• Be aware that grapefruit juice and grapefruit products may interfere with Vivelle Dot's effects and increase the risk of side effects. It's probably best to avoid these products while taking Estradiol.
• Overdosing on Vivelle Dot may result in abdominal pain, breast tenderness, fatigue, nausea, vomiting, and other adverse effects. If you think you've overdosed on Vivelle Dot, promptly contact a medical professional or poison control center.

Possible Vivelle Dot side effects

Some of the most common Vivelle Dot side effects include:

• Anxiety
• Back pain
• Breast tenderness
• Depression
• Exacerbation of existing conditions
• Fluid retention
• Headaches
• Irregular vaginal bleeding or spotting
• Sinus inflammation
• Thinning hair
• Upper respiratory tract infections
• Weight gain
• Nausea and/or digestive issues

Many more Estradiol side effects - mild, moderate, and severe - are possible while using Vivelle Dot. In some cases, Vivelle Dot may provoke allergic reactions. In addition, it's important to note that Vivelle Dot may increase the risk of several serious health conditions, including:

• Breast cancer
• Cardiovascular issues including increased blood pressure or heart attack
• Coronary heart disease
• Dementia (particularly in the cases of patients over the age of 65)
• Elevated blood pressure
• Endometrial cancer (Vivelle Dot comes with a black box warning re: endometrial cancer)
• Gallbladder disease
• Hypercalcemia or hypocalcemia
• Hypothyroidism
• Ovarian cancer
• Stroke
• Vision issues