How do you regulate dosage of the Estradiol patch?

[Pleroma]

After 4 weeks with the Estradiol Vivelle-Dot (delivers 0.05 mg/day), my E2 reading was 43 - which is a lot higher than I want it. 12-30 is the range.

I did not have a baseline E2 test before applying the patch, but assume after 3 years of ADT, it would have been pretty low.

Does anyone have some thoughts on dosage or your own experience?

Thanks.

[GP24]

I am on a Bicalutamide monotherapy and my E2 is now 50,9. This does not cause any problems. It may improve your bone health so you do not need Zometa.

[Pleroma in reply to GP24]

Is there any concern that high E2 levels might become a source of fuel for the cancer? Or higher risk of blood clotting, maybe?

[GP24 in reply to Pleroma]

Bicalutamide may start to feed the cancer after some time but I never heard that E2 will do that. Also I am not aware that it is a risk for blood clotting. I think the improvement in QoL is more important than an unproven risk.

[GP24 in reply to GP24]

To answer your original question, you can reduce the dose of E2 by not using a new patch that often. You can vary from a new patch every three days down to every seven days.

[Pleroma in reply to GP24]

Yup, that is what I was thinking.

[Wassersug]

Pleroma,

According to your earlier postings, you have BRCA positive PCa and have been treated with a PARP inhibitor. So why are you now on estradiol (E2)? Are you still being treated by Kwon at the Mayo? Did he put you on E2?

I can discuss E2 dosing with you; we would just need to find a convenient time for voice contact. You can message me individually and directly with times and numbers for contact, if you want to talk.

Richard W.

[Pleroma in reply to Wassersug]

I stopped Olaparib after 8 months as it was no longer working. During that time I also had an orchiectomy which increased the hot flashes both in quantity and intensity, so talked with my Mayo MO about mitigating the side-effects with Estradiol. Dr. Kwon has a secondary role in my health decisions - unfortunately - as he can only go so far with prescribing what is essentially an MO's job. For those reading this post, Kwon is a urologist, but with a strong leaning toward prostate cancer research.

[EdBar]

I’ve been using patches for years now to help with ADT side effects, as I understand it the dose released in your bloodstream is highest in the first 2 days, perhaps that is a factor.

Ed

[noahware]

One problem in attempting to regulate dosage by monitoring blood work is that E2 lab results are likely to vary a bit, at least partly depending on when you last changed the patch.

In the PATCH trial (for high dose, not the lower dose you do), I believe the protocol called for doing testing on the day before or day of (but still before) the changing of the patches. Maybe this was because doing labs right after a patch change could show an E2 level a bit higher than the average.

I believe your brand is a 2x weekly patch. If the desire is to stay on the lower side of that 12-30 range, perhaps change the patch less frequently... maybe instead of 2x weekly try 2x every ten days, or even just one patch a week?

[Pleroma in reply to noahware]

Useful information - thanks - I do not know at what point I was E2 tested.

Get tested a day or two before the next patch is a good plan.