New Hormone Spray for Menopause

Now women have another choice for menopause symptom relief. Evamist is the first estrogen therapy to be made available in a spray. During menopause, the ovaries stop producing the hormone estrogen. This can result in bothersome symptoms like hot flashes, vaginal dryness, night sweats and loss of libido. Since the goal of treating menopause is to use the smallest dose of estrogen that controls symptoms, Evamist contains a low dose of estradiol that is sprayed onto the forearms.

There is a major advantage of using topical forms of estrogen, like Evamist, versus the pill form. Estrogen that is swallowed in a pill must pass through the liver. This can actually increase triglycerides. Increased triglycerides are associated with an increased risk of heart disease. Since topical estrogens are absorbed through the skin, they bypass the liver's metabolism. Topical estrogens do not affect triglycerides the way estrogen pills do.

Women will use 1 to 3 sprays of Evamist once a day. Initially, most women will start with one spray per day. Women may work up to two or three sprays a day depending on how well symptoms are controlled. Keep in mind that it takes 7 to 8 days for the concentrations of Evamist to build up in the body after you start your dose. For this reason, allow at least 7 to 8 days to see what kind of symptom relief you will have before changing the dose.

It is also important to keep in mind that women with a uterus who use any type of estrogen product should also take progestin as it helps reduce the risk of endometrial cancer. Women without a uterus do not need to take progestin.
When trying Evamist for the first time, make sure you prime the spray pump. The pump is primed by spraying three sprays in the upright position with the cover on. After the initial priming, it is not necessary to prime the pump before each dose. When spraying on the skin, make sure the plastic cone applicator is flat against the skin. This helps ensure the dose being delivered is accurate. It is recommended that Evamist be applied to the inside of the forearm between the elbow and wrist. Evamist should never be applied directly to the breast or vagina.

Evamist should be applied at the same time everyday to help ensure consistent blood levels of estradiol. If more than one spray is needed for one dose, make sure you move the cone to a different area of skin on the forearm for each new spray. Take care not to overlap the area of the previous spray. It is best to allow the spray to dry for a couple of minutes before dressing. Wait at least 30 minutes before washing the area or allowing others to come in contact with the area. Do not massage or rub Evamist into the skin. Take care to avoid smoking or flame until Evamist has dried on the skin as it contains alcohol-based liquid that is flammable.

Oddly enough, it is important to apply sunscreen at least an hour before applying Evamist. Applying sunscreen one hour after use has been shown to decrease the absorption of Evamist. The effects of applying lotions, however, has not been studied. The manufacturer does not offer any recommendations to the timing of the application of lotion with Evamist.

Side effects for Evamist are similar to other estrogen products. Nausea, headache, abdominal pain and breast tenderness are possible side effects of its use. Evamist should not be used in women who have a history of abnormal genital bleeding, deep vein thrombosis, pulmonary embolism or liver dysfunction. It should not be used in women with a history of breast cancer or other estrogen-dependent cancers. It should also not be used in women who have experienced a stroke or heart attack in the last year.

Although this is the first estrogen spray, it is not the first topical estrogen product. There are also patches, gels, creams and vaginal products available. There are no head to head trials showing that Evamist is any better than any other estrogen product on the market. Therefore, the product you chose to use will be based on preference and what type of symptoms you are experiencing. Evamist costs about $23 to $70 a month depending on the dosage.

So is hormone therapy right for you? The American College of Obstetrics and Gynecology (ACOG) and the North American Menopause Society recommend that only women who are experiencing symptoms of menopause should consider hormone therapy. If hormone therapy is used, the lowest possible dose that allows for symptom relief should be used. They also recommend that women who are only experiencing vaginal symptoms use topical products rather than estrogen pills. If you are experiencing symptoms of menopause and are considering hormone therapy, talk to your doctor about which option is right for you.