Switching to transdermal patches

[Alana Ashleigh]

I had my appointment with my new hrt doctor. The appointment went very well. I asked to be moved from oral estradiol to a patch. The doctor didn't object, and sent it the pharmacy. Will I notice a difference being on a patch vs taking it orally?

[Lori Dee]

Will I notice a difference being on a patch vs taking it orally?

I believe you will. Oral tablets must first pass through the liver, so the doses are typically higher to achieve the same effects. The patches bypass the liver and slowly absorb into your bloodstream. This means that you dose can be lower and still do the same job. It may take a week or two before you notice, but you should feel much better.

With tablets, my hormone levels would rise and fall every day. It was miserable. The patch lasts for 3 - 5 days, so the rollercoaster effect evens out. I only had the hot flashes, night sweats, and moodiness when it was time to change patches. Then my endo changed to twice-a-week patches. That smoothed things out a bit more.

The only problems I had were keeping the patches on. The generic (Mylan brand) would come loose from sweating. My doctor added Tegaderm to put over the patches to hold them on. The problem was that the Tegaderm wasn't big enough to cover the patches. The pharmacist changed it from Tegaerm to an IV cover. The film is very thin, covered the patch, and was ventilated so the skin could breathe beneath it. That was a HUGE improvement!

Then the problem was that the generic patches did not raise my hormone levels enough. We switched from the Mylan brand to the Grove brand. The patches (mini-dot) were so much better. But we later figured out that my metabolism is too fast for patches, and I got switched to injections.

Everyone's metabolism is different, so hopefully, the patches will work well for you. If you have problems with them staying stuck on, ask about covering them with IV film. The brand is Smith & Nephew IV3000. They are just under 3 inches by 3 inches square.

Let us know how the patches are working for you. Good luck!

[Jessica_Rose]

Most patches adhere to skin much better than pills, even with duct tape.

Lori covered it pretty well. Some people develop rashes related to the patch adhesive, switching brands may help. The only issue I had with patches was around the edges of the patch, where the adhesive seems to attract debris. After only a day or two, you may notice a debris ring around the patch. When you replace the patch, use some baby oil on the old adhesive. After a few minutes, the old adhesive will become much easier to remove. Try to place the patch on an area that doesn't typically have a lot of friction with clothing. I typically placed patches a few inches below my belly button, slightly off-center, so I could alternate sides.

The parches did work very well for me, but after a few years I switched to injections. It took me a month or two to get used to doing it, but I find it more convenient now.

Love always -- Jessica Rose

[ChrissyRyan]

I do sublingual and avoid the liver issues of swallowing the tablets.
At $4 a month or 30 pills this is also inexpensive for me.

[KathyLauren]

I have been on patches from day one, due to being old.  My doctor wanted to take it easy on my liver.  Fine by me.

There is a huge variation among brands, especially between generic and name-brand patches.  I have used generic (Sandoz) and Estradot brand (also Sandoz), and there was no comparison.  The generic patches were enormous, limiting the available sites on my body, and requiring me to re-use the same patch of skin too frequently.  The adhesive was an irritant, causing nasty rashes.  And the adhesive was water-soluble, so they would come off in the shower.  The Estradot patches are much smaller, so I can go a full month without re-using the same bit of skin.  They are less irritating to my skin.  And the adhesive is oil-soluble, meaning that they stick in the shower.  It means that I need a bit of bath oil to remove the remaining adhesive when I remove them, but that only takes a minute.

I had to plead with our drug plan to let me use the more expensive name brand patches, but they agreed that the skin rashes from the generic were sufficient justification to do so.

[Lori Dee]

The generic patches were enormous, limiting the available sites on my body, and requiring me to re-use the same patch of skin too frequently. 

I had the same issue with the large generic (Mylan brand) and the small Grove minidot brand.