Susan's Place Transgender Resources

I'm pretty jazzed to step things up a little bit, doc just bumped up my script. I use those minivelle patches, and they are kind of big IMHO. Really open to hearing what you all that are using two patches are doing?

History (you can probably skip this, but I think it is worth noting here). I have tried a few configurations...
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- First on the abdomen with no covering. It was horrid. I constantly worried about it all the time, and then I would get this ring that would need to be scraped off. I still have a scratch ring from the first one  >:(
- Then on my backside. This is cumbersome to do solo, but then again I'm not very coordinated using mirrors haha. I guess I could have asked my wife?
- After that I started using tegaderm over the patch, switching back to the abdomen, and that was much much more comfortable. I don't really like it on my front. I think it might trigger a little dysphoria - weird, right?
- This week, back to the backside so to speak, using the tegaderm. I think I have the placement figured out right so that I don't have issues worrying about it getting messed up. Feels good and I'm happy with this.
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Now I have two of these things to apply, twice a week.
I don't know where I'm going to find the space LOL. I'm not very big (5'10 129), and with two of these things side by side, I don't know if I'm going to get good placement on my backside, while rotating so that my skin doesn't get irritated. I try to give each area a full week to recover... I guess I could do it on the front, more usable area there.

I've thought of maybe doing one on my abdomen and one on my backside, and just alternating left and right side, bottom and top. Kind of like a figure 8, ya know? But again, really not big on having it on my abdomen.

Anyone have experience with two patches that can give some input?

I could also switch to taking pills under the tongue (the only way my doc will allow me to take pills over the patch), but I hate the taste of pills dissolving. It makes me gag. Plus she is pretty conservative with treatment, which isn't bad, but I'm afraid she'll want to be extra-super-duper cautious with the sublingual delivery, because she hasn't done it with any of her patients before.

Did this post make sense?

Maybe I'm overthinking it.

I use two patches, but I use the smaller Vivelle-Dot/Estradot patches.  They are small enough that I put them close together.  If I have any issues with them coming off I use kinesio athletic tape on top of the patch.  I have never used the minvelle patches, but I hear that the Vivelle/estradot patches stick better and have less of a skin reaction.

I started out on the patches and fell victim to the same problems you have outlined. When my endo upped my dosage and I had to do the two patches as well, that was the end of the patches for me. I made it a month and decided to go to the injections. Best decision I've ever made (other than coming out)!! They last two weeks and you don't have to worry about adhesive residue and they are cheaper than the patch!! It's a viable option if you are ok with needles but not everyone is :)

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I use two patches twice a week also. They are made by Mylan, a generic version of the Vivelle dot, except they are not round, they are small rectangles.  In any event, I place one on each cheek, moving them around a bit to give the skin a break.  I haven't had too much problem with them coming off or skin irritation, although I can see a slight red outline of the patch when I take them off.

My problem is that even with four patches a week at the highest strength, my estradiol levels are only around 70 pg/mL. I wish I had higher blood levels, but I am not sure I want to do five or six patches a week, so I would have to ask my endo about injections.

Interestingly, I have noticed discussions on the internet by women using transdermal estradiol patches for post-menopausal symptoms, and there are many claims that the delivery systems are not the same - they don't give the same effect for the same dose. The Mylan patches are often a culprit. Even the Sandoz generics are supposed to be better.

~Terri

Quote from: jessical on April 29, 2016, 08:16:20 PM
I use two patches, but I use the smaller Vivelle-Dot/Estradot patches.  They are small enough that I put them close together.  If I have any issues with them coming off I use kinesio athletic tape on top of the patch.  I have never used the minvelle patches, but I hear that the Vivelle/estradot patches stick better and have less of a skin reaction.

+1
if they stick better they may be more effective.
The patches need skin contact to work.

Many people report problems with generics.

Possible may be one patch for steady levels and sublingual bioidentical estrogen.

Peoples skins are different so there may be different absorption rates.

Also possible are bioidentical estrogen gels, injections, and implants .

Many endos strive for levels of e of 80-200 pg/ml or above, and of t below 60 ng/dl.

Talk it all through with your doc.


hugs

All interesting feedback. I thought about trying the vivelle, but I am terrified to see what the price on those are. My insurance doesn't chip in much if there are alternatives to name brand :( FWIW I think the Mylan Minivelle is actually working quite well. I've had noticeable physical and mental changes in the past 6 weeks, so that's good :) I want to ask the doc for another test on my hormone levels, but I also don't want a lab bill  ::)

The injection delivery is interesting, I haven't heard my doctor say one word about it but have read about it here and elsewhere. I am not afraid of needles when other people are wielding them, but sticking myself might be problematic. I guess I need to, at the very least, try doubling up for a bit and then have some lab work for a new baseline. We haven't tested for T or E since I started. T was ~860, so I'm curious to see where it is these days. 

Regarding the Mylan, I have read some stuff about them that weren't very good, but majority of the negative comments are from several years ago. I'm thinking they may have fixed those issues. This is purely conjecture though. I like guessing.

Anyways thanks for the tips! If I come up with anything to add later, I will. The two patch business starts tomorrow.

J

I use the generic Sandoz and haven't had any sticking, unless I put them in a really bad spot, like I did today ;) I don't know how big they are compared to what you are using right now though. I couldn't imagine trying to fit two at a time on me... and they are smallish

I use two of the Sandoz patches and they are not too bad in terms of sticking.  Every once in a while, they will stick to my panties and the corners will come loose, but mostly they stay where they are put.  I change mine out more frequently than most, 3 times a week and we have managed to get my E over 100 pg/ml consistently.  No complaints.  Also, and this is more based on my genetics than anything I am sure, my clinical results have been awesome using them.

I have not had any issues with irritation with the Sandoz, but did with a different brand my old pharmacy provided.

Yeah, I don't know about the Sandoz patches :-/ I was able to make it work today, both on the backside. I got smart and asked my loving and supportive wife for help in lining them up to minimize real-estate. One thing was weird though, the two that we used , it seemed like the adhesive wasn't as good as the previous pack. I found that kind of odd (and a little disconcerning?). Needless to say the Tegaderm has kept everything smashed tight against my skin, so I'm relying on that to do it's thing.

I've been on the mylan patches for about a year now and JUST crested 90 pg/ml.  I'm tired of the sticky residue and them coming off on my clothes.  I find they just are one day there and the next poof... gone. I also feel I've not made any real delevopmental progress since moving to patches.. it is like I hit a wall. I really want to go to IM but my doctor is suggesting topical cream...  I'm not a fan of this route, but we'll see.

I had the same problems with applying two patches at the same time. I also tried pills and topical cream but I was very unsatiesfied with the results. So I switched to IM, by far the best method in my opinion.

Quote from: HeatherR on May 02, 2016, 12:17:31 PM
I've been on the mylan patches for about a year now and JUST crested 90 pg/ml.  I'm tired of the sticky residue and them coming off on my clothes.  I find they just are one day there and the next poof... gone. I also feel I've not made any real delevopmental progress since moving to patches.. it is like I hit a wall. I really want to go to IM but my doctor is suggesting topical cream...  I'm not a fan of this route, but we'll see.

Concerning patches best to stick seem to be vivelle/estradot.
Generics or others are made differently.


hugs

Gah, well now I'm second guessing the patches altogether then. I wish there was an easy answer, but life doesn't work that way, does it? :)

The Mylan patches have got to be the worst - They wouldn't stick most of the time and if they did the skin rash they left behind was horrendous - Switched to the Novartis Vivelle-Dot and they were a God-send - Small and stuck well without any real nasty reactions but they were expensive even with insurance - About a year or so ago the Vivelle-Dot went generic but they are actually the exact same product - Novartis kept on producing them in the same factory but they now carry the Sandoz manufacturer name - Of course Sandoz is a subsidiary of Novartis - At least now they are considered generic and the price cut was substantial

be well
jenifer

I'll keep this updated in case someone comes along and is curious... I just started on the pills sublingual per doctors orders on Saturday evening. It became apparent to me over the next few days that I was NOT getting the same input of medicine. She told me to take an extra amount which starts today, so we'll see how that goes. Luckily my doctor is THE bomb. Seriously, I sent her a message at 12:15PM and received a reply before 1PM :)

J

I am not on HRT yet so I don't have direct experience with the patches but I am a diabetic. I wear an insulin pump and a continuous glucose monitor sensor. Both of these go on my belly. It's kind of the same issue where the challenges is to keep them stuck on during their life. The pump site stays on for about 3 days and the sensor stays on for up to 7 days. I use a product called I.V. Prep to prep the site before I put them on. They are basically alcohol preps but it leaves the skin somewhat sticky which helps them stay on, especially in the summer months when it gets warm and when I sweat. I order them from my pump supplier but they might be available elsewhere. The pump supplier is Medtronic. Here is a picture of the package if that helps finding it. Good luck. Jenny b(https://www.susans.org/proxy.php?request=http%3A%2F%2Fuploads.tapatalk-cdn.com%2F20160602%2F6ffd53225ba009437317345aed9ed8f9.jpg&hash=8ff155bc923d400cf450657ca1cd3af7d772f2a2)




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