Pills vs. patches

[April221]

A few days ago, I went to a new doctor for my prescription. I had been using patches, but was having problems with them not staying in place, wrinkles, loosening in the shower, and was unhappy with the idea of using them for the rest of my life.  When I asked the doctor about Vivelle-Dot, which I understood to be a smaller patch, his response was that he really didn't like the patches, because studies showed that the patch had a higher clotting risk than the pills, 2% vs. 3%.  Every web site, every on-line resource that I had read prior to beginning HRT stated that patches were the safest of all methods, less strain on the liver than pills, and maintained a constant blood level. I have had good results as well. He wasn't impressed by my statement that the patch was easier on the liver...he said that everything goes through the liver. If that's correct, there may not be any gain in terms of safety by sub-lingual use of  the pills. He's a doctor in New York City, and has many TS patients on HRT. I'll eventually go to injections, but has anyone read anything to indicate that the pills are safer than the patch? 

[Tanya1]

I think that's exactly why you should ask a doctor instead of getting information off the net on some site where you don't know where the author got this information from and if it is even currently up to date on research. If you really had the time, it'd be better to pick an advanced textbook on endocrinology and to find up to date information on Hormone Therapy. You should be weary of TS websites offering information that can be a alternative to a doctor's words.

Well, he is correct. Everything goes through the liver. In fact, Mcdonalds is a lot harder on the liver than the pills. Plus those pills don't much strain on the liver than does wine or beer.

As to the clotting factors. Well I'm no qualified medical expert but the risk of stroke, heart disease, cancer is still there in my OPINION despite what method it is taken. Clotting I have absoulety no clue about since I'm not a doctor but I do find that many TS's seem to think patches and injections will end all the risks- not true.

But what I did read was that the body finds hormones in the liver and thinks there is internal bleeding and starts clotting.

LOL, why do you want to know the reasons as to why so much?

[Purple Pimp]

Well, I'm no M.D., but that doesn't sound right.  I'd get a second opinion from another doctor if I were you; saying patches have a higher clotting incidence goes against everything I've ever heard (emphasis on "heard".  I've only ever actually looked at studies comparing pills to injections).

Lia

[taru]

I think that's exactly why you should ask a doctor instead of getting information off the net on some site where you don't know where the author got this information from and if it is even currently up to date on research. If you really had the time, it'd be better to pick an advanced textbook on endocrinology and to find up to date information on Hormone Therapy. You should be weary of TS websites offering information that can be a alternative to a doctor's words.

The problem is that doctors contradict each other. Which endos should we believe? The one claiming that transdermal has higher clotting risks or the ones claiming that transdermal has lower clotting risks? Or maybe being informed is a good idea.

Well, he is correct. Everything goes through the liver. In fact, Mcdonalds is a lot harder on the liver than the pills. Plus those pills don't much strain on the liver than does wine or beer.

Actually avoiding the first pass makes the pharmacokinetics quite different. The most important thing is to use bio-identical estradiol and avoid smoking.

Most studies seem to point at lower clotting risks associated with transdermal than oral estrogens.

[Tanya1]

The problem is that doctors contradict each other. Which endos should we believe? The one claiming that transdermal has higher clotting risks or the ones claiming that transdermal has lower clotting risks? Or maybe being informed is a good idea.


Actually avoiding the first pass makes the pharmacokinetics quite different. The most important thing is to use bio-identical estradiol and avoid smoking.

Most studies seem to point at lower clotting risks associated with transdermal than oral estrogens.

Yes, doctors do indeed contadict each other. Many have their bias. Example some say that progestorone is helpful for breasts while others say that it doesn't help.

So who should you believe? Well I've "Heard" that nobody did some research on progestrone to begin with! - So I would say you should stay nuetral BUT every female has that hormone in their body- thus it would probably be more conclusive to use it.

[Christine Eryn]

I was on patches for about 2 months, and I was changing once a week in a different location religiously. I have a slight but visible half circle scar on my hip that my doctor warned me about, patches "burn" some people. I switched to a gel called Divigel that seems to be working great for me. As for pills I've never taken them.

[Berliegh]

I was in various pills from 1998 to 2007 and I found the results limited....your liver has to break them down..

More recently I've been on patches which for me seem to work much better than the pills.....