This study aimed to evaluate the impact of transdermal estrogen therapy on health-related quality of life (HRQoL) and treatment tolerability in postmenopausal women in a real-world setting.

A prospective, non-interventional study was conducted in Sweden and Finland. Participants used a spray delivering 1.53 mg of estradiol (E₂) per 90 µl dose. HRQoL (measured using the Menopause Rating Scale [MRS]), dosing patterns and treatment satisfaction were assessed through web-based questionnaires at baseline, week 6 and week 12. Mixed-model repeated-measures analysis was performed.

Of 249 participants (mean age 52.1 years), 165 (66.3%) completed the 12-week follow-up. Most women (67.2%) used one or two sprays daily. The mean MRS total score was 17.8 at baseline, and decreased by 8.6 points at week 6 (p = 0.012) and 9.9 points by week 12 (p < 0.0001). Improvements were seen across all MRS domain scores (somatovegetative, psychological and urogenital), including hot flashes, sleep issues, depressive moods and sexual problems. Most participants reported satisfaction (78.8%), ease of use (95.2%) and willingness to recommend the spray to a friend (84.2%). No related adverse reactions were reported.

The E₂ spray improved HRQoL and was well tolerated. Flexible dosing, ease of use and real-world effectiveness support that the spray is a practical, user-friendly treatment for menopausal symptoms.