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Hormone Cream: Effects, Uses and Side Effects

A hormone cream is a topical preparation containing hormones applied directly to the skin. It is commonly used in hormone replacement therapy to treat conditions such as menopausal symptoms.

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Things worth knowing about "Hormone cream"

A hormone cream is a topical preparation containing hormones applied directly to the skin. It is commonly used in hormone replacement therapy to treat conditions such as menopausal symptoms.

What is a Hormone Cream?

A hormone cream is a topically applied medication or medical product that contains one or more hormonal active ingredients. The cream is applied directly to the skin, where the active substances are absorbed into the body through a process called transdermal absorption. Hormone creams are available both as prescription-only medications and as over-the-counter products, depending on the type of hormone and its concentration.

Active Ingredients and Types of Hormone Creams

Hormone creams may contain different types of hormones. The most commonly used active ingredients include:

Estrogens (e.g., estradiol, estriol): Used to treat menopausal symptoms and local vaginal dryness.
Progestogens (e.g., progesterone): Often combined with estrogens in hormone replacement therapy.
Androgens (e.g., testosterone): Less commonly used, for example in cases of low libido or hormonal deficiency in men.
Corticosteroids: Synthetic hormones with anti-inflammatory properties, used for skin conditions such as eczema or psoriasis.

Areas of Application

Hormone creams are used in a variety of medical contexts:

Menopausal symptoms: Estrogen-containing creams relieve symptoms such as hot flashes, dry mucous membranes, and vaginal dryness.
Vaginal atrophy: Local estrogen creams can be applied directly to the vaginal area to regenerate the mucous membranes.
Hormone replacement therapy (HRT): As an alternative to tablets or patches, creams allow for flexible dosing.
Skin conditions: Corticosteroid creams are used for inflammatory skin conditions such as atopic dermatitis, psoriasis, or allergic reactions.
Anti-aging: Some over-the-counter products contain small amounts of hormones or hormone precursors and are marketed for skin care, although their efficacy is scientifically disputed.

Mechanism of Action

After application to the skin, the hormonal substances penetrate the outermost skin layer, known as the epidermis, and enter the bloodstream or act locally within the tissue. Transdermal absorption bypasses the so-called first-pass effect of the liver, which breaks down a portion of orally ingested hormones before they reach the bloodstream. This means that lower doses can be used with hormone creams to achieve a comparable effect to higher-dose oral preparations.

Dosage and Application Instructions

The application of a hormone cream should always follow medical advice or the instructions provided in the package leaflet. Key application guidelines include:

The recommended amount (often specified in grams or measured doses) must not be exceeded.
The cream is typically applied to intact, clean skin.
Certain application sites (e.g., forearm, thigh, abdomen) are recommended by a physician, as the absorption rate varies depending on the body area.
The skin should not be washed immediately after application to ensure adequate absorption of the active ingredient.
Skin contact with other individuals, especially children, should be avoided at the treated area.

Side Effects and Risks

Like all hormone-containing medications, hormone creams can cause side effects. These depend strongly on the active ingredient and the duration of use:

Estrogen-containing creams: Possible side effects include breast tenderness, nausea, headaches, or, in rare cases, an increased risk of thrombosis.
Corticosteroid creams: Long-term use may lead to thinning of the skin (skin atrophy), telangiectasia (visible blood vessel enlargement), or an increased risk of infection.
General: Local reactions such as redness, itching, or burning at the application site are possible.

Women with certain pre-existing conditions, such as hormone-dependent tumors, should use estrogen-containing preparations only after careful medical evaluation.

Prescription Requirements and Availability

In many countries, hormone creams with higher active ingredient concentrations are prescription-only and can only be obtained from a pharmacy with a valid prescription. Some products with low hormone concentrations, particularly estriol creams for local vaginal treatment, may be available over the counter under certain conditions. Corticosteroid creams are either prescription-only or available over the counter, depending on their potency.

References

Stute, P. et al. - S3 Guideline on Peri- and Postmenopause (2020). German Society of Gynecology and Obstetrics (DGGG). Available at: https://www.awmf.org
Federal Institute for Drugs and Medical Devices (BfArM) - Product information on estradiol-based topical preparations. Available at: https://www.bfarm.de
The NAMS 2022 Hormone Therapy Position Statement Advisory Panel - The 2022 hormone therapy position statement of The Menopause Society. Menopause, 29(7):767-794 (2022).

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