The endochrinologist said that he wants to prescribe either an injectable, or transdermal patch.  Both have great benefits, but also drawbacks.  I would like to use transdermals, but there are concerns about adhesion.  While injections require only one visit to the injection clinic every two weeks so they are super convienient, but they don't have uniform dose level throughout the two week period.  I do all the blood work tomorrow, so the prescription won't be written until next week.

It seems I always have some sort of question, and here's another.  I'm seriously leaning to the patch, but still on the fence.  So what kind of good or bad experiences have you girls had with either injections or transdermals?

Thank you.

Kathy

Have you considered transdermal creme? No patch to deal with, I just apply a small scoup of the stuff 2X a day. A months supply is like $35 and keeps levels even, unlike injections. Womens international pharmacy can compound any strength or type of hormone you need and all are bio-identical.

Injections!!!!!!!!!!!!!

lol, I don't know. As someone who is on injections and has getting pretty generous results (or that could be my youth, idk) I pretty much swear by them.

Also, they're kinda cheap if you don't limit yourself to delestrogen.

Quote from: Stephe on September 11, 2012, 09:56:08 PM
Have you considered transdermal creme?

The Endo mentioned them but said he would prescribe injections or patch in my case due to age. 

Quote from: Ave on September 11, 2012, 10:12:25 PM
Injections!!!!!!!!!!!!!

I'd love to use injections but there are limitations to my travel when I'd need to go to a clinic every two weeks.  And my healthcare fully covers the costs so I'm not really concerned except for the need to travel to a clinic, which could be real expensive now days.

How about a transdermal gel? My endo says they're completely equivalent to patches, but without the adhesive concerns (possible allergies, it might come off for some reason, etc.). According to him, they're completely replacing patches on the market for postmenopausal women, and prescribing patches is something they nowadays only do if the patient insists.

Also, something I learned about transdermal gels: they're great for giving you a good baseline level of oestrogens all day and all night, contrary to all other methods, but the current products on the market (the most popular probably being Estrogel 0.06 % [mods: this is the product's name, and I didn't say how much of it you use]) being aimed at post-menopausal women, according to a credible-looking website with information for self-medication (which I won't name, of course), using a gel or patch still requires you to get additional estradiol from elsewhere, because your blood levels don't go high enough from them alone; for pills, it cuts the required dose by about half depending on the case, but it doesn't eliminate the need for them.

Unless that website isn't as complete as it feels and there's some way doctors know of for making the dose higher with only transdermals, like applying it multiple times a day or over a larger area, or that there are higher dose products available, even though the Internet remained mute on them.

Rest assured, I'm not thinking of self-medicating; I was just hungry for information in the wait before my endo appointment and feeling a bit betrayed because my E levels at 4 months were still in the male range.

I can testify for this, since I was on a low dose of Estrace for a few months, and seeing the still mostly absent development after changing that for Estrogel, I still don't think my levels are sufficient.

But despite all that, I'm still 100 % for transdermal, even if it requires something else on top. It has a lot of benefits, that I've been noticing even though my dose is still way too low:

-The random slight horniness/frustration/aggressivity I used to get around 21:00 if I'd forgotten my Estrace at supper, an indication that my levels were fluctuating if you ask me, is gone. So my levels are more stable.

-With a gel, you can actually target areas and it seems to work. You have some variety as to where to put the gel, and you can alternate, or not. Especially in the beginning, I was mainly putting it on the hips, and surprise, hip growth came faster than it used to, and body hair got reduced faster in the area. I guess it's because since the oestrogen was stored in the skin close to them and released right next to them, they got some sort of "priority" for "feeding on it". Listen to the package though: never put it on your breasts or face.

I'm not a fan of injections at all, with the huge roller coaster of levels they represent (+ I'm scared of needles), with possibly suboptimal results (genetic girls start with low levels and the increase is very gradual*, so it makes sense to me, even though I know of no study on this), but I can't deny them that advantage: they're much cheaper than transdermals, and also cheaper than pills, probably.

*Evolution of estradiol levels in girls along puberty, according to http://www.allinahealth.org/CCS/doc/Consumer_Lab/49/150066.htm

QuoteFemale Tanner Stages [3]

    Tanner stage 1: 5-10 pg/mL (18-37 pmol/L)
    Tanner stage 2: 5-115 pg/mL (18-422 pmol/L)
    Tanner stage 3: 5-180 pg/mL (18-661 pmol/L)
    Tanner stage 4: 25-345 pg/mL (92-1,266 pmol/L)
    Tanner stage 5: 25-410 pg/mL (92-1,505 pmol/L)

I have been using estrodot (vivelle)patches and sandrena and oestrogel together for the past 10 months and have no problems. Any residue left by old patches is easily cleaned off with baby oil.

Are transdermal cremes legal in the US?

I'm currently on patches and have been for about 3 mo. They do tend to want to come off in the shower. Or if i work up a good sweat. I go back to see my endo tomorrow hope she'll switch me to injection. She already said she do's not like to perscribe pills for HRT.

UC, I can't say about cremes, but probably. I know gels, at least, are. I've read quite a few experiences about Americans on it, and uhm. My gel is made in the US, so.

 OK let me see if I can clear up what seems to be some misconceptions. Gel and creme as the same, just a different delivery base. I like the creme because it's easy to apply and feels nice. I could just as easily get a gel prescribed if I wanted. Yes they are legal in the US but require a prescription.



Like others said, this delivery method gives an even dose of meds without the spikes in E levels shots give. I'm paying for mine out of pocket and a month supply at this latest dosage is ~$30 + shipping. I really think this is the future of hormone medication. No going in for shots, no crazy expensive patches and none of the problems with oral meds. I think it's worth showing this info to your doc or maybe even have them mail an information packet to your doctor and tell him to look for it. I don't think a lot of doctors know this type of service exists or how reasonable their pricing is.

Dosages removed.

There are a couple of different methods in use for injection.  One of my friends is on an 'intra-muscular injection' regimen, where she injects herself once every two weeks.  I have heard that some girls have difficulty with the hormonal swing by the end of the 2nd week (my friend does just fine with it though).
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Personally, I inject Delestrogen once per week on a 'subcutaneous injection' regimen.   The needles are smaller for this (regular 29 gauge needles that are more commonly used for insulin with diabetes patients), and the dosages are smaller in order to help maintain a more even hormone level.  I've been on this regimen for about a year, and it has been working pretty well to keep my levels both in the proper range and keep them fairly level.   I would definitely recommend the subcutaneous method. 

I'm not sure why you would have to go to the clinic for regular injections.  It's really very simple to do it yourself.  After cleaning the area with an alcohol pad, pinch the skin on your upper leg into a mound, slide the needle in, inject, remove, apply the band-aid, and you're done.  The nurse showed me how to do it my first time, and I was on my own from there.  My clinic is 150 miles away from where I live, so going into the clinic on a regular basis isn't practical for me either.  Now that my doseage is stable, I actually won't be back to the clinic for another year. 

The main negative I've heard about patches is the adhesion, especially in arid climates, the summer or anytime you sweat (exercising, etc...)  But I do have a friend that has had positive results with those too. 
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Hope this helps,
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Kaitlyn

I had good luck with the Climara weekly patches as long as I covered them with a 3M Tegaderm waterproof dressing (they are like big clear bandaids without the pad in the middle). The tegaderms are designed to stay on a week, but are still breathable.

I'm allergic to most adhesives, so eventually I got too sensitive to the glue in the patches, so my endo switched me to every two weeks self injection. IM had the added advantage for me of not giving me an uncomfortably low E level on the last day or two of the week.

Quote from: kathy b on September 11, 2012, 09:29:09 PM
The endochrinologist said that he wants to prescribe either an injectable, or transdermal patch.  Both have great benefits, but also drawbacks.  I would like to use transdermals, but there are concerns about adhesion.  While injections require only one visit to the injection clinic every two weeks so they are super convienient, but they don't have uniform dose level throughout the two week period.  I do all the blood work tomorrow, so the prescription won't be written until next week.

It seems I always have some sort of question, and here's another.  I'm seriously leaning to the patch, but still on the fence.  So what kind of good or bad experiences have you girls had with either injections or transdermals?

Thank you.

Kathy

I live in the U.K and injections are not licensed or available here, so I've never tried injections (which I would like to try if I can import them somehow?). I've tried transdermals or patches and they had very little effect on me.

I don't think you girls who live in America know how lucky you are to actually have choices in what medication you can have. 

Quote from: Naturally Blonde on September 12, 2012, 03:25:01 AM
I live in the U.K and injections are not licensed or available here, so I've never tried injections (which I would like to try if I can import them somehow?). I've tried transdermals or patches and they had very little effect on me.

I don't think you girls who live in America know how lucky you are to actually have choices in what medication you can have.

The hormone solutions for intramuscular injections are compounded (mixed together precisely from raw ingredients to create the precise drug content prescribed by the physician) by a chemist who specializes in the custom compounding of (usually prescription) drugs. In almost all countries, the healthcare professional who issues prescriptions are not limited to commercial drugs mass produced by the large drug companies.

I know of one compounding pharmacy in the UK but there are probably others. They are also known as independent bespoke pharmacies.
http://www.specialist-pharmacy.com/

Quote from: MadelineB on September 12, 2012, 03:36:58 AM

I know of one compounding pharmacy in the UK but there are probably others. They are also known as independent bespoke pharmacies.
http://www.specialist-pharmacy.com/

I have emailed the company in the link you provided. Here's their reply:

Hello,

Unfortunately we can not make injectable products. We compound bio-identical hormones as cream or lozenges.

Kind regards,

Deirdre.

Kay: I think the main reason is that most people just don't have the skill required to do the injection. It seems pretty easy to a lot of people, but even if they shown me, past the fear of the pain and needle, I would still be paralysed by my own incompetence.

Naturally Blonde: These people look like they're saying they do intramuscular injectables as well. Maybe it helps you. It does say "international", so I'd guess that they export. http://www.womensinternational.com/formulations.html

I'm using Estrogel (in the UK, but the gel seems to manufactured in France mostly) - very easy to apply, dries fast, very good results. I avoided patches because of allergies, and tablets didn't work.

Just a point to keep in mind. In  my group there is the those on pills, patches and injections. Most have used more than one type over the years. Apparently, depending on the type of E there are different response and side effects.

I have used all 3. I am not a big fan of pills, big PITA. The patch is mostly OK. The edges do tend to lift up depending on activity or sweating which leads to total disaster in the shower. Also finding just the right spot to apply it that isn't too rollie-pollie can be a pain. There is also a little bit of sensitivy to the adhesive to deal with. If the skin under an elastic plaster gets red after a week, expect the same from a patch

Overall injectable is the winner in my eyes. The results were the best. However, after a few years and the ocassional opps, you get a little reluctant to jab that needle in yourself. If it was being done by someone else, no-prob at all I think

Quote from: Padma on September 12, 2012, 05:22:07 AM
I'm using Estrogel (in the UK, but the gel seems to manufactured in France mostly) - very easy to apply, dries fast, very good results. I avoided patches because of allergies, and tablets didn't work.

I tried Estrogel years ago and found it did absolutely nothing for me! Pills work a little bit better but the results are far from satisfactory.

Quote from: A on September 12, 2012, 05:11:01 AM
Naturally Blonde: These people look like they're saying they do intramuscular injectables as well. Maybe it helps you. It does say "international", so I'd guess that they export. http://www.womensinternational.com/formulations.html

The problem is injectable HRT is not licensed in the U.K so I may have trouble importing it without a prescription?

Quote from: JoanneB on September 12, 2012, 05:31:38 AM
Overall injectable is the winner in my eyes. The results were the best. However, after a few years and the ocassional opps, you get a little reluctant to jab that needle in yourself. If it was being done by someone else, no-prob at all I think

I'm not surprised by your findings. You guys in the USA are lucky you have choices and are not bound by the awful NHS we have in the U.K who are about 20 years behind everyone else when it comes to GD treatment.

Quote from: Kay on September 12, 2012, 12:46:27 AM
I'm not sure why you would have to go to the clinic for regular injections.  It's really very simple to do it yourself.

The Endo didn't offer up self injections but, I'm going to ask because there is another trip to michigan next month and it wouild interfere with the injection schedule.  Maybe he's afraid I'd double up on injections since I have a real problem with self medicating.  But he did say he needs to monitor my levels for several weeks after starting, so it's possible he is just trying to control the first month or two. 

Quote from: A on September 12, 2012, 05:11:01 AM
Kay: I think the main reason is that most people just don't have the skill required to do the injection. It seems pretty easy to a lot of people, but even if they shown me, past the fear of the pain and needle, I would still be paralysed by my own incompetence.

Yes I am a bit scared of injecting myself with a large IM needle.  It'll be quite intimidating, but probably more than worth the benefit of eliminating clinic visits.

Kathy