Lenzetto

Lenzetto is a transdermal estradiol spray for the treatment of menopausal symptoms. It is the only available estrogen spray therapy and offers a practical alternative to tablets, gels, and patches.

The spray is applied to the forearm once daily. The estradiol is absorbed through the skin and enters the bloodstream directly without passing through the gastrointestinal tract (no first-pass effect in the liver).

Women with an intact uterus must also take a progestogen (e.g., Famenita).

Estradiol through the skin (transdermal):

Mechanism of action:

• Estradiol is sprayed onto the skin
• The spray dries quickly and forms an invisible film
• Estradiol is absorbed through the skin into the bloodstream
• Compensates for the estrogen deficiency after menopause

Advantages of transdermal application:

• Bypasses the first-pass effect in the liver
• More even hormone levels than with tablets
• Lower risk of thrombosis than with oral intake
• No effect on blood clotting factors

Effects:

• Relieves hot flashes and night sweats
• Improves sleep and mood
• Prevents vaginal atrophy
• Protects against bone loss

Lenzetto is suitable for:

• Postmenopausal women with menopausal symptoms
• Women who want to avoid tablets and patches
• Women with an increased risk of thrombosis (transdermal preferred)
• Women who are overweight (absorption through the skin may be reduced, so a dose adjustment may be necessary)

Advantages:

• Invisible (no visible patch)
• Quick-drying
• Easy to use
• Lower risk of thrombosis than tablets

Not suitable:

• In case of contraindications to HRT
• On damaged or irritated skin

Lenzetto spray:

• 1.53 mg estradiol per spray

Starting dose:

• 1 spray daily on the forearm

Dose adjustment:

• Increase to 2-3 sprays daily if needed
• Aim for the lowest possible effective dose

Note: Women with a uterus: also take a progestogen (e.g., progesterone)!

Application: 1. Spray onto the inner side of the forearm between the elbow and wrist 2. Hold the pump upright 3. 1 spray from a distance of approx. 5 cm 4. Allow to dry for 2 minutes 5. Do not rub! 6. Wash your hands

Important notes:

• Always at the same time of day
• Several sprays side by side on non-overlapping areas of 20 cm² each
• Do not wash the area for 1 hour
• No sunscreen on the spray site (before or after)
• Avoid skin contact with other people for 1 hour

Do not use in case of:

• Breast cancer (known or suspected)
• Estrogen-dependent tumors
• Unexplained vaginal bleeding
• Active thrombosis/embolism
• Severe liver disease
• Porphyria

Use with caution in case of:

• Risk of thrombosis
• Uterine fibroids
• Endometriosis
• Migraine
• Diabetes, high blood pressure

Pregnancy/breastfeeding: Contraindicated.

Common (1-10%):

• Breast tenderness
• Headache
• Rash
• Itching

Uncommon:

• Nausea
• Weight gain
• Mood changes
• Bloating

Rare:

• Thromboembolism (lower than with oral administration)
• Gallstone disease

Note: Change the spray site regularly (right/left arm).

Interactions:

• CYP3A4 inducers – reduced estrogen effect
• Sunscreens – may reduce estradiol absorption (allow time between the two applications)

Special note: Transdermal application has fewer interactions than oral estrogens.