HRT: Estrodiol Tansdermal Patch?

[StephanieSoCal]

Hello friends,
I'm a 50 year old M2F gal who has just started HRT. I've been on spironolactone for three weeks. My doctor also proscribed an Estradiol Transdermal Patch that I haven't started it yet. I felt too intimidated to raise any objection in my initial appointment. But as I thought about it more, I wasn't happy with his choice. I haven't started the estrogen course because I don't like the idea of the patch. I have concerns about privacy; I don't wan anyone to see me wearing it at the gym or when my shirt comes up at work. Another issue is that I surf and don't think the patch is up to the rigors of my lifestyle. I would prefer injections or oral tablets.
I am seeing my doctor for a follow up appointment and plan to discuss estrogen delivery options. Before that appointment/discussion, I'm hopping that some of you make a bit smarter about the options and perhaps why he, my doctor, might have initially chosen the patch? Pros? Cons?

[Lisa]

Hi Stepahnie,

I've been on the patch myself for about 3 months now.  I discussed all 3 options with my doctor before starting and we both agreed that the patch was the best choice for me.

My understanding is that if you can manage to take the oral tablets sublingually (dissolved under the tongue rather than swallowed), then they should have similar risks to the other forms, but swallowing them partially or entirely can put a little more strain on the liver, and may further increase the risk of blood clots.

Between the patch and the injections, the patch provides a steadier dosage, and might result in fewer mood swings, headaches, and other symptoms of hormone fluctuations.

I've not had any trouble with the patches coming off, even when showering and scrubbing the area, but different manufacturers' patches may vary in how well they stay on.

I usually wear mine a bit above the waist, and I don't generally go anywhere topless (not that I could at this point!), so I've not had any privacy issues.

Your mileage can and likely will vary on this (I'm in my 30s), but if you're concerned about changing at the gym, or being seen in swimwear, etc., keep in mind that regardless of what format you use, at some point you will likely have other things that would out you, or at least raise some questions, and possibly sooner than you think

-Megan

[Violet]

I have been on the patches for almost 2 years now.  Also I was told to put them on my butt cheeks. They stay on very well, in fact, I have to use Acetone to remove the adhesive that gets left behind when I change them!


(Dosages edited by moderator)

[KathyLauren]

Hi, Stephanie!

Welcome to Susan's.

The deciding factor for your doctor in prescribing the path was probably age.  I am 63, and my doctor was quite clear that I was getting the patch because of my age, even though I am in excellent health.  The patch is one of the safer methods of delivery, causing less risk to the liver than oral hormones.  Doctors are very risk-averse.

I wear my patches below the belt line.  Since no one but my wife and doctor see that area, there is no risk to privacy.

I have had some problems with perspiration in hot humid weather causing the patches to lose some stick.  A shower makes it worse, but only if the perspiration has already loosened it.  I had no problems over the winter.

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[Charlotte F]

Hi Stephanie

I have been using patches for just over a year.  I started with Evorel which were generic patches around 2 inches square and these did regularly come off when exercising for extended periods.  As a cyclist I also had an issue where the patch was quite tough and caused friction cuts to the skin on longer rides in the summer.  My doctor changed me to Estrodot which are tiny little patches (around 1 inch square for a typical starting transition dose) and these can easily be worn on a butt cheek.  Since using them, these patches have been faultless and I just alternate between sides each time I change patches (makeup remover or baby oil easily removes the residue)

Doctors do generally prescribe patches to older ladies (I think over 40) due to supposed lower risks of DVT.  The alternative is gel (applied daily) which is popular with some women and of course is completely invisible

Charlotte

[StephanieSoCal]

Dear Megan, Charlotte, Kathy & Violet,

Thank you all so much! Those were some great, very thoughtful answers. It really helps a great deal!

Steph