Frequently Asked Questions About Cyclic Therapy

There are two treatment options for CombiPatch. The first, continuous combined therapy, uses CombiPatch all month. But the second option, cyclic therapy, uses both CombiPatch and an estrogen-only treatment. Here’s a few commonly asked questions and answers about cyclic therapy.

What is cyclic therapy?

Will I experience menstrual-like bleeding while on this therapy?

What are Vivelle-Dot (estradiol transdermal system) and CombiPatch?

Where should I apply the patch?



What is cyclic therapy?

This treatment is for women who have a uterus and are experiencing moderate to severe menopausal symptoms1. The treatment uses estrogen only, such as Vivelle-Dot, for the first two weeks and estrogen and progestin combined, such as CombiPatch, for the last two weeks of your 4-week cycle. Progestin is added to estrogen for women with a uterus, because if estrogen is given alone, it can sometimes cause excessive growth of the uterus lining that can lead to cancer. This risk is greatly decreased by adding progestin. Before menopause, progesterone was the hormone your body produced that was responsible for the monthly shedding of the uterine lining, which you experience as your period. Taken with estrogen after menopause, progestin acts similarly. For important safety information about Vivelle-Dot, click here.

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Will I experience menstrual-like bleeding while on this therapy?

Yes, this treatment often results in a regular, predictable bleeding, at the same time of the month, each month. Discuss your bleeding pattern with your doctor to see if follow-up care is needed.

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What are Vivelle-Dot and CombiPatch?

Vivelle-Dot provides estrogen only, and CombiPatch provides estrogen and progestin. Both are small, ultra-thin patches that are worn on your lower abdomen (stomach). Vivelle-Dot and CombiPatch release hormones through the skin and directly into your bloodstream.

For women who are interested in the source of the hormones in their therapy, the estrogen in Vivelle-Dot (estradiol) and the estrogen and progestin in CombiPatch (estradiol and norethindrone acetate) are chemically synthesized from plant sources. This does not mean that Vivelle-Dot and CombiPatch are safer or more effective than other hormone therapies.

CombiPatch and Vivelle-Dot use the patented DOT Matrix technology. “DOT” stands for “Delivery Optimized Thermodynamics.” These patches are specifically designed for convenience. Despite being so small, Vivelle-Dot and CombiPatch provide controlled, sustained release of hormones over 3 ½ days.

The patches are applied to your lower abdomen just twice a week. In clinical trials, the patches stayed on well and had a low occurrence of skin irritation. The patches are designed to stay on during various activities including swimming, showering and bathing. So you can enjoy an active lifestyle while wearing them.

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Where should I apply the patch?

Apply the patch twice-weekly to your lower abdomen below your waistline. Change the location each time you put on a new patch. Get more information on applying the patch.

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See Vivelle-Dot Prescribing Information PDF.

WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT COMBIPATCH (A COMBINATION OF ESTROGEN AND PROGESTIN HORMONES)?

Do not use estrogens and progestins to prevent heart disease, heart attacks, strokes or dementia (decline in memory and thinking skills). Using estrogens with progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots, and may increase your risk of dementia.

Do not use CombiPatch if you have had your uterus removed (hysterectomy). CombiPatch should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.

The most common side effects that may occur with CombiPatch are breast pain, vaginal bleeding, and headache.

1CombiPatch is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; and treat certain conditions in which a young woman’s ovaries do not produce enough estrogens naturally. If you use CombiPatch only to treat your dryness, itching and burning in or around the vagina, talk with your health care professional about whether a topical vaginal product would be better for you.

You and your health care professional should talk regularly about whether you still need treatment with CombiPatch and whether you are taking the lowest dose that works for you.

WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT VIVELLE-DOT (AN ESTROGEN HORMONE)?

Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).

Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).

Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.

The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.

Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman’s ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.

You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.