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Estracomb TTS is a sequential transdermal hormone replacement therapy (HRT) patch system developed by Ciba-Geigy (now Novartis). It is indicated for the relief of menopausal and postmenopausal symptoms (such as hot flashes, sleep disturbances, and urogenital atrophy) and the prevention of postmenopausal osteoporosis in women with an intact uterus. The sequential regimen consists of two types of patches: Estraderm TTS (delivering estradiol only) used for the first 14 days of a 28-day cycle, followed by Estragest TTS (delivering a combination of estradiol and norethisterone acetate) used for the remaining 14 days. Estradiol acts as an agonist of estrogen receptors to alleviate estrogen deficiency symptoms, while norethisterone acetate, a synthetic progestin, acts as a progesterone receptor agonist to prevent estrogen-induced endometrial hyperplasia.
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