Vivelle-Dot® – Estradiol

Vivelle-Dot® (Estradiol) Description^1-6

Micronized estradiol is a bioidentical form of 17β-estradiol, the primary estrogen produced by the ovaries in premenopausal women. It is used in a variety of hormone therapy (HT) regimens and can be considered one of the preferred estrogen formulations for menopausal women due to its bioidentical structure and favorable risk profile when appropriately prescribed. When applied topically and absorbed transdermally, micronized estradiol does not undergo first-pass metabolism through the liver, this leads to the favorable risk profile as the first pass-effect of estradiol causes the greatest increases in thromboembolic factors. Vivelle-Dot® (estradiol transdermal system) contains estradiol in a multipolymeric adhesive. The system is designed to release estradiol continuously upon application to intact skin.

Vivelle-Dot® (estradiol transdermal system) has the following indications 1) Treatment of moderate-to-severe vasomotor symptoms associated with the menopause; 2) Treatment of moderate to severe symptoms of vulvar and vaginal atrophy associated with the menopause; 3) Treatment of hypoestrogenism due to hypogonadism, castration, or primary ovarian failure; and 4) Prevention of postmenopausal osteoporosis.

References

1. Cynthia A. Stuenkel, Susan R. Davis, Anne Gompel, Mary Ann Lumsden, M. Hassan Murad, JoAnn V. Pinkerton, Richard J. Santen, Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 100, Issue 11, 1 November 2015, Pages 3975–4011, accessed July 2025 through: https://doi.org/10.1210/jc.2015-2236 
2. Estradiol transdermal system (Vivelle-Dot) https://www.novartis.com/us-en/sites/novartis_us/files/Vivelle_DOT.pdf Distributed by: Novartis Pharmaceuticals Corporation East Hanover, NJ 07936 Approved October 2021. Accessed July 5, 2026.
3. North American Menopause Society (NAMS) Position Statement (2022): “The 2022 Hormone Therapy Position Statement of The North American Menopause Society” https://www.menopause.org/docs/default-source/professional/2022-nams-ht-position-statement.pdf 
4. Sobel TH, Shen W. Transdermal estrogen therapy in menopausal women at increased risk for thrombotic events: a scoping review. Menopause. 2022 Jan 14;29(4):483-490. doi: 10.1097/GME.0000000000001938. PMID: 35357370.
5. Canonico, M., Oger, E., Plu-Bureau, G., Conard, J., Meyer, G., Lévesque, H., … & Scarabin, P. Y. (2007). Hormone therapy and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration and progestogens: the ESTHER study. Circulation, 115(7), 840-845.
6. Clinical Pharmacology estradiol clinical monograph accessed July 2025 through: https://www.clinicalkey.com/pharmacology/monograph/1330?n=Estradiol Accessed July 5, 2026