The patches are thin pads that adhere to the skin and deliver estrogen directly to the bloodstream. They are placed on the buttocks or abdomen and changed once or twice a week. Unfortunately this method doesn't seem to have the same beneficial effects on HDL as oral estrogen. Creams containing estrogen and progestin can be applied directly to the skin usually over the abdomen, arms, or thighs. The cream is absorbed from the skin into the bloodstream.
Creams allow for a balanced dose because they're administered daily.
However, application can be messy, and you can inadvertently apply an improper amount. Creams can produce higher levels of estrogen than standard oral regimens or patches, so blood estrogen levels need to be carefully monitored. Vaginal creams containing estrogen can be helpful for women who have only vaginal menopausal symptoms such as dryness or itching. Contrary to common belief, estrogen does enter the bloodstream when applied vaginally. Therefore, the same risks and benefits associated with other forms of estrogen also apply to vaginal creams.