Switching to transdermal patches

[Tills]

Oh wow, thanks Lori-Dee. That's all extremely helpful information.

As well as the issue about adhesion, I hadn't considered the idea that the patches wouldn't deliver sufficient dosage. I think they're available in four different strengths in the UK so it will be interesting to see what my Gender Clinic advocate.

I have a cis female friend who has no problems with Evorel patch adhesion but I guess it's going to be a case of trying them out, with regular hormone level monitoring in the early stages.

I have reached the point where the gels are pretty invasive. My morning dose is the higher of the two and applied to my thigh. This means I have got into an ingrained habit of waking early (3.30 or 4 am) to apply the dose, waiting an hour or more for it to dry, and then going back to sleep. This has been going on for more than two years and it's a bad sleep pattern. Then the afternoon dose involves hitching up a sleeve and spreading it over my arm: hardly ideal if you are out and about. And both doses require careful planning with baths or showers.

xx

[Lori Dee ✅]

I think you might be happier with the patches. The adhesion could be a factor of skin moisture and maybe even acidity. Just watch for sensitivity. If one leaves a rash, switch to the other brand. If adhesion becomes the only issue, try an IV cover to keep it in place. It can't deliver its dose if it isn't stuck in place.

😀

[Charlotte_Ringwood]

I should really move to patches as they don't really recommend oral after age 40 due to risk of blood clots. But patches are extremely expensive!

Hopefully will be ok as only on 4mg oral so it's not too high.

Does sound from this thread patches have their issues too though. There is a spray Lenzetto available on prescription now in uk giving about 1.5mg per spray. Being DIY though I can't get it 😕

Charlotte 😻

[Lori Dee ✅]

I should really move to patches as they don't really recommend oral after age 40 due to risk of blood clots. But patches are extremely expensive!

Hopefully will be ok as only on 4mg oral so it's not too high.

The biggest problem with oral tablets (not sublingual) is the first-pass through the liver. The metabolites (leftovers) can affect blood coagulation. Hence, the blood clot/stroke warnings. The other problem is that, because of being processed in the liver, the effective dose must be higher so that enough makes it into the bloodstream to be effective. Higher dose = higher risk.

Other methods bypass the liver, such as sublingual drops, sprays, gels, patches, and injectables. They all have their pros and cons, but for some, one method works better than others or is more convenient, as Tills pointed out. Although I would never recommend DIY, I do understand your situation with the availability of a provider.