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Estradiol Patch: How long do they actually deliver estrogen?

Started by LauraE, August 08, 2018, 02:24:17 PM

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LauraE

I've been on patches for a month now and while I've felt no effects yet (except for a complete loss of libido due to Spiro), I'm curious about patch duration. Unfortunately, I've been unable to find any information online about how long the patches actually release estrogen. Do the dump most of it in the first few days? Are they timed to last seven days? Is there any benefit for leaving them on longer if they might still have estrogen to release?

Thanks in advance.

Laura
When you're ready, start living your truth.
That's when the magic happens.


Laura Full-Time: November 27, 2020

My FFS Journey   | One New Life to Life (my blog)  |  Should I Stay or Should I Go |   My Breast Augmentation


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KathyLauren

It might epend on which patch you are on.  I know that mine are supposed to last 3-1/2 days.  Each patch contains 80x the daily dose.  In other words, in the 3-1/2 days, I am absorbing only 4.4% of the estrogen in the patch.

So, I would say that, while the absorption rate no doubt decreases over the time the patch is on, the decrease is not a lot.  The patches are rated according to the daily absorption rate, and I think it will not change a lot.  Loss of stickiness due to sweating or showering is probably a bigger factor in the absorption rate than running out of E in the patch: it isn't going to run out.

It would be important to keep the patch on for the full time, in order to get the dosage that your doctor wants you to have.

I am pretty good about remembering to change my patch on time.  On occasion, I have forgotten for a day.  If that happens, I sometimes apply the new patch on time but don't take the old patch off until its 3-1/2 days are up.  I don't know if that helps even it out or not.
2015-07-04 Awakening; 2015-11-15 Out to self; 2016-06-22 Out to wife; 2016-10-27 First time presenting in public; 2017-01-20 Started HRT!!; 2017-04-20 Out publicly; 2017-07-10 Legal name change; 2019-02-15 Approval for GRS; 2019-08-02 Official gender change; 2020-03-11 GRS; 2020-09-17 New birth certificate
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MissyMay2.0

If you aren't noticing effects you may want to ask your provider to check your blood estrogen level, and if it's too low they may prescribe you a higher dose, but it's probably not a good idea to leave the patches on longer than you're supposed to, because it's possible that your blood estrogen level is where it should be, but you just need to allow more time for changes to occur.
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Devlyn

Quote from: lauraelliott1951 on August 08, 2018, 02:24:17 PM
I've been on patches for a month now and while I've felt no effects yet (except for a complete loss of libido due to Spiro), I'm curious about patch duration. Unfortunately, I've been unable to find any information online about how long the patches actually release estrogen. Do the dump most of it in the first few days? Are they timed to last seven days? Is there any benefit for leaving them on longer if they might still have estrogen to release?

Thanks in advance.

Laura

Let's say you leave the patches on longer than prescribed, and they're still releasing estrogen. Your levels will be a little higher, and  your doctor will increase your dose by a lesser amount based on that level. You'll have locked yourself in to wearing a string of old tattered patches.

Change them out when you're supposed to, and  reach your estradiol level on clean, fresh patches.

Sincerely, Doctor Dev  :)
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LauraE

I really appreciate all of you chiming in. I've only been on patches four weeks, and yes, that means one patch per week. I know it's normal to double up after a few months (and I'm dying to get to that point.). I think Dr. Dev is probably right about not keeping them on longer than a week, even though they may still be discharging estrogen, because that could provide false numbers during my blood test.  maybe after I double up.

Last time I transitioned, I felt the "tingling" around the four week mark, so I'm hoping for those feelings soon

Thank you much.

Laura
When you're ready, start living your truth.
That's when the magic happens.


Laura Full-Time: November 27, 2020

My FFS Journey   | One New Life to Life (my blog)  |  Should I Stay or Should I Go |   My Breast Augmentation


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Devlyn

Quote from: lauraelliott1951 on August 08, 2018, 06:34:35 PM
I really appreciate all of you chiming in. I've only been on patches four weeks, and yes, that means one patch per week. I know it's normal to double up after a few months (and I'm dying to get to that point.). I think Dr. Dev is probably right about not keeping them on longer than a week, even though they may still be discharging estrogen, because that could provide false numbers during my blood test.  maybe after I double up.

Last time I transitioned, I felt the "tingling" around the four week mark, so I'm hoping for those feelings soon

Thank you much.

Laura

Full disclosure: I  was leaving the old patch on, too. Until I thought about what it was really doing.

Hugs, Devlyn
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JudiBlueEyes

After reading that I should be careful upon removing the old patch because it still contained estrogen, I left them on until the next morning (an extra 24hrs) to see if if there was any additional effect.  I haven't noticed anything and my levels have been consistent so I now remove them when I put the new ones on.  I'm on the 7 day variety.
But now old friends they're acting strange
They shake their heads, they say I've changed
Well something's lost, but something's gained
In living every day.
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Dani

All patches, regardless of which medication they contain, will still have a significant amount of medication remaining in them even after the recommended changing interval. Used patches should be folded in half before disposal so that there will be little chance of absorbing the medication through accidental contact. This is not very important with Estradiol, but is extremely important with controlled drugs used for pain relief such as Morphine or Fentanyl.

How much is remaining after the patch is removed? It varies somewhat, but there is enough to supply at least 90% of a full dose on day 7. On day 8 the release of medication does not go to zero, but gradually decreases every day thereafter if the patch is still in contact with the skin or some other surface to allow the medication to be released. The specific amount is different for each manufacturers patch. You have to look at the pharmacokenetic profile of each manufacturer's patch to determine how much active medication is still available. Because of this, some patches are worn once a week and others are twice a week.
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pamelatransuk

Quote from: KathyLauren on August 08, 2018, 03:09:11 PM
It might epend on which patch you are on.  I know that mine are supposed to last 3-1/2 days.  Each patch contains 80x the daily dose.  In other words, in the 3-1/2 days, I am absorbing only 4.4% of the estrogen in the patch.

So, I would say that, while the absorption rate no doubt decreases over the time the patch is on, the decrease is not a lot.  The patches are rated according to the daily absorption rate, and I think it will not change a lot.  Loss of stickiness due to sweating or showering is probably a bigger factor in the absorption rate than running out of E in the patch: it isn't going to run out.


Quote from: Dani on August 09, 2018, 03:54:47 AM
All patches, regardless of which medication they contain, will still have a significant amount of medication remaining in them even after the recommended changing interval.

How much is remaining after the patch is removed? It varies somewhat, but there is enough to supply at least 90% of a full dose on day 7. On day 8 the release of medication does not go to zero, but gradually decreases every day thereafter if the patch is still in contact with the skin or some other surface to allow the medication to be released. The specific amount is different for each manufacturers patch. You have to look at the pharmacokenetic profile of each manufacturer's patch to determine how much active medication is still available. Because of this, some patches are worn once a week and others are twice a week.

Kathy/Dani

I am on 3/4 day patches but choose to change every 84 hours such that each patch is given same usage.

I have noticed the arithmetical point you mention - there appears to be much more available and therefore wasted E after we remove the patch. Do you happen to know why the patch usually contains so much E in the first place if so much less is required please? I am not disappointed myself that they do contain too much but surely it is not cost effective financially or even environmentally?

Thanking you

Pamela


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Dani

Pamela,

Patches are designed to deliver a given amount of medication in a specific interval, such as mg/day or similar release rate. The recommended interval for changing is based on pharmaceutical standards that require at least 90% of labeled amount to be released into the skin is accurate.

The cost of the active ingredients is minimal compared to the cost of manufacturing and marketing the patch. Financially, you are paying for the delivery system more than anything else.

Environmentally speaking, all mammals eliminate metabolized hormones in their urine. Modern sanitation systems take care of this when properly operated.

Yes, when using a patch there is a lot of wasted hormone that is never absorbed. We are not really buying the hormones. We are buying a specific delivery system that is accurate, safe and effective that will get us the results we need.
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pamelatransuk

Thank you Dani for your concise explanation which I appreciate and understand.


Pamela


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SaraDanielle

I don't know a lot about the actual transdermal delivery system, but it is fair to assume the process works through diffusion of small molecules (estrogen in this case) into the dermal layers and then into the capillaries.

Diffusion is a nonlinear process that depends on the concentration in the patch and the concentration in the skin.  With a large difference in concentration, the diffusion will happen faster.  It is also likely that the patch quickly approaches a steady-state, and provides a very even administration of the hormone, which I see as an advantage over taking a pill.

If you read through the literature provided with the patch, or do a google search on Vivelle Dot Pharmacokinetics,  you will see the effective dose (as measured in plasma) charted out for days 1 through 4 (at least for the 3.5 day patch). 

I'd recommend following their recommendations and removing the old patch.  It's possible it becomes less effective, and less even as the patch wears out.



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Violet

I have been using 2 patches twice a week for almost a year now. Took about 3 months after starting before I noticed any changes which mostly have been mental for me. Lately I am noticing some body fat relocation (around my belly of course!) LOL! I would not recommend leaving old patches on due to the risk of blood clots. ♥
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christinej78

Have been on Estradiol patches since 27 March 2018. The first thing I noticed was at the fourth day I was able to pee better than I had been able to for twenty years. My prostate was quite enlarged, I was 77 at that time and on Flomax (Tamsulosin the generic). It helped very little over the time I was on it. Once I was sure the Estradiol was the reason for the improvement I ditched the Flomax. I'm almost five months in and quite a few changes have occurred. I've developed a noticeable set of "Parking lights" which I hope evolve into "Headlights" and ultimately aircraft "Landing Lights." My avatar is me without any help from Photoshop, I'm now78.

Don't know what lies ahead; some facial surgery for sure, nose job (big job) will be the first then wrinkle removal (bigger Job) next. I'll never again look 25 so I will not travel that illusionary highway. I have spent way too much time exposing my epidermis to the destructive radiation produced by el sol, rarely if ever using sun block. I've already had two skin cancers removed and have to have rechecks every 6 months. Constantly having precancerous lesions removed. ADVICE: If you are going to expose your skin to the sun, use high SPF sunblock. That beautiful tan will come at a high cost down the road.

I never used  AAs (spiro, etc.), had my orchiectomy Friday 13 April 2018, about 17 days after  starting HRT. I have had no mood swings, hot flashes or anything unpleasant. My ability to urinate is now at what I remember from my early adult  years mid 30's, about half my life ago. I'm happier than I have ever been, most aggression is history. Still have some learned aggression to unlearn, which is happening. My emotions are definitely more feminine, my Dogs even like me more than they did the old man. I've only had one rejection by a so called friend (so called because a real friend would never reject a friend). I wear women's clothing almost exclusively; I say almost because I will wear some of my old men's rags when doing "dirty" chores or when it is raining, in which case I revert to my old men's sneakers.

I do not make any attempt at passing as female because at this time that would be impossible. What you see in my avatar is what you get (WYSIWYG) and is how I present; I mostly wear a lot of pink and other feminine colors to a lessor degree. I get a lot of smile from women and young folks. Old white men that give me what I perceive as "disapproving" looks are met with direct eye contact and a smile. Works every time.

I feel it is our right to be what and who we want to be as long as we are not physically harming any other being. If someone doesn't like what we are doing, doesn't mean we are harming them; they are harming themselves with their bigotry, ignorance, and sometimes their sheer stupidity, which cannot be fixed. My Dysphoria was never crippling or life threatening, which I am grateful for. I know a lot of you suffer greatly from it, which I didn't know about prior to my own transitioning process and coming here to Susan's Place. You are in the right place for advice and help.  Lots of great help and advice from those that have gone before you, already having traveled the road you are on.

Sorry this ended up being so long. Sometimes I just can't shut up; it's the hormone's. Best of luck in your greatest life's adventure.

Best Always, Love
Christine
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