Can You Go in a Hot Tub Wearing an Estrogen Patch?

Menopause is a normal part of aging. But the symptoms can be bothersome and interfere with your life. Hormone replacement therapy (HRT) is the first-choice treatment for managing moderate-to-severe vasomotor symptoms of menopause, such as hot flashes and night sweats.

HRT comes in many dosage forms, including oral pills, topical creams, and transdermal (skin) patches. If you use estrogen patches, there are tips you can follow to make sure they work safely and effectively. For example, there can be problems if you get them wet or expose them to heat. This means you might need to take caution in certain situations, including time relaxing in a hot tub.

Below we’ll tell you all you need to know about estrogen patches and hot tubs.

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How do estrogen patches work?

Hormone levels, such as estrogen, fall during menopause. This leads to a constellation of symptoms, such as hot flashes, night sweats, and vaginal dryness. Supplementing estrogen with HRT can improve these symptoms.

Estrogen patches are applied to the skin once or twice weekly. Your skin absorbs a steady flow of estrogen from the patch. This could make it an appealing option if you have trouble swallowing pills. There’s also some evidence that patches may provide higher and steadier levels of estrogen compared to oral HRT.

How heat affects estrogen patches

Not enough research has been done on how heat affects estrogen patches specifically. But there’s information regarding how heat affects medicated patches in general.

Studies suggest that when you apply heat to medicated patches, the way your body absorbs the medication may change. It’s possible that your body could absorb medication quicker or in greater amounts than usual. This can raise your risk for side effects.

As mentioned, there are no studies that look specifically at heat and estrogen patch absorption. But based on the information discussed above, there may be a risk of greater estrogen absorption when exposed to direct heat. So it’s something to consider if you’re a fan of heating pads or heated blankets.

Another potential issue with heat and estrogen patches is that it may not stick to your skin as well. That’s because sweating can interfere with the patch’s adhesive. So it’s possible your estrogen patch may come off more easily. Keep this in mind if you’re doing activities that might make you sweat, such as exercising, using a sauna, or taking a hot bath.

EXPERT PICKS: WHAT TO READ NEXT

• Get to know the patch: Pharmacists review the ins and outs of estrogen patches — from potential benefits to side effects.

• Patches, gels, and sprays: Learn about the various recommended dosages for estrogen.

• Cutting costs: Treating menopause symptoms doesn’t need to break the bank. Check out this comprehensive menopause treatment savings guide to see how you can save.

What are the risks of wearing estrogen patches in hot tubs?

The risks of wearing estrogen patches in hot tubs would be similar to those described above. It’s possible your body could absorb more estrogen than expected. If this happens, you might experience more side effects than usual. Common HRT side effects include headache, nausea, and breast tenderness.

Your patch may also fall off more easily. Keep in mind there’s no specific warning about hot tubs in estrogen patch labeling. But there is a warning that bathing, swimming, or using saunas could make the patch less sticky. It’s reasonable to extend this caution to hot tubs as well.

Consider removing your patch before entering a hot tub and replacing it after. Normal showering shouldn’t result in the patch falling off, as long as you limit direct contact with water. If you tend to use hot tubs frequently, it may be good to discuss alternative forms of HRT with your prescriber. There are other pill-free options, such as topical gels and sprays, that wouldn’t require these safety measures.

Estrogen patches: Dos and don'ts

There are many tips that can help set you up for success when it comes to using estrogen patches. Below are some dos and don’ts to keep in mind.

Estrogen patch dos:

• Apply patches to clean, cool, and dry areas on your lower abdomen or buttocks.

• Remove your old patch before applying a new one.

• Choose a different area of your abdomen or your buttocks each time you replace patches.

• Fold together the sticky sides of used patches after removing it and before throwing it away. This helps prevent exposing others to any medication left on the patches.

• Talk to your prescriber if you don't have any relief of menopause symptoms within 4 weeks of starting the estrogen patch.

• Let your prescriber know if you experience unusual vaginal bleeding, lumps in your breast, or severe headaches after starting the estradiol patch. These are not typical side effects and could be signs of more serious problems.

Estrogen patch don'ts:

• Don’t cut estrogen patches. They haven’t been studied to show whether cutting them interferes with the patches’ safety or how well they work.

• Avoid applying patches to the waistband area. This can cause friction and lead to the patch falling off.

• Avoid using the same application site within the same week.

• Don’t apply estrogen patches to your breast area.

• Don’t apply more than one patch at a time. This increases your risk of side effects.

• Don’t flush estrogen patches down the toilet.

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Written by:

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP, has over a decade of experience as a pharmacist, professor, and researcher. She was a full-time clinical professor in the pharmacy practice department at D’Youville School of Pharmacy before subsequently joining the faculty of the pharmacy practice department at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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