HRT - Gel or Patch?

[Florrie2]

Hi. I’m new to this Community but have been on the Endometriosis UK one since last year.

Since having a hysterectomy, I’ve spoken briefly to a doctor about HRT. She gave me a link to do some research but I can’t find anything that has pros and cons of patches over gel - apart from keep the gel away from animals as it can affect them badly. I am a ‘picker’ so pick my fingers and any bumps on my skin (I know, horrible..) so was concerned I may feel the patch and want to pick at it. It seems more convenient then the gel though? I saw you have to apply it daily all over your arm or thigh then wait an hour before putting on moisturiser.

I’ve had Endometriosis excised as well so will be looking at combined HRT which may well be patch/gel oestrogen and pill form for progesterone.

Thanks in advance for any experiences.

[Smithy999]

I only got the option to have patches from my dr. I stick them on my hip/thigh area so they're not anywhere I can pick at them, and they stick really well. 2 months in and it's working well so far, hot flushes gone, hair and skin are better and I can get a full nights sleep again. There is a great app called Balance which has lots of great info about all the different types of HRT so have a look at that. Good luck x

[Wales99 in reply to Smithy999]

I’ve just started on patches. Literally my first one today! I read in the instructions not to stick it in the same place twice (I have to change it twice a week) but I’m not sure how you would know? I’ve stuck it at the top of my thigh & thought Next time I can stick it on the other leg.

[Smithy999 in reply to Wales99]

I swap from one leg to the other and just move it slightly away from the outline of the last one! That's the only annoying thing is that you get a black outline on your skin from clothing fibres sticking to the edge of the patch. You can remove them with oil, or scrub hard in the shower!!

[Wales99 in reply to Smithy999]

Yes I know! It is slightly annoying. I scrubbed it in the shower with my exfoliating sponge & thought I’d got rid of it then as soon as I put clothes on the black mark came back 🙄. I’ve heard baby oil works. Might try that. I can put up with that I just pray they work. 😊.

[Florrie2 in reply to Wales99]

Okay, so now you are putting me off patches 😁

[Wales99 in reply to Florrie2]

😂. Oh no sorry! Didn’t mean to put you off. It’s just a minor inconvenience- the benefits far outweigh the drawbacks IMO. 😊.

[Hidden in reply to Wales99]

How long did it take for your hot flashes to go away with the patch? I've been on the estradiol 0.75 mg patch for a little over 3 weeks and I still have not gotten any relief of hot flashes yet. I'm worried it's not going to work since it's not worked by now???

[Wales99 in reply to Hidden]

Hi. Goodness it was a long time ago now but I think it was a couple of weeks. I’ve switched to gel now - I wasn’t absorbing the patches. I much prefer the gel.

[Hidden in reply to Wales99]

Okay thanks. I will ask my doctor what to do when I get to see her in a week but I'm pretty sure she just wants me to keep on giving it more time but that's really frustrating when you're getting no relief and just getting the side effects of the patch. I've heard that other people have problems absorbing the patch so I'm wondering if maybe that's the problem is that maybe I'm not even absorbing it? I was wondering if oral would be better absorbed as I don't think my insurance would pay for the gel. Also I'm on the generic of Dottie because my insurance only pays for that one generic patch they don't let me get any brand that I want so I'm wondering if that has something to do with it too.

[Hidden in reply to Wales99]

Oh I wanted to know too... How did she know that the patches that you weren't absorbing them? Because that's the big thing that I want to know is if my body is even absorbing them? As this is what I feel like might be happening with me if I'm not getting symptomatic relief but yet I am getting the side effects like discharge and sore boobs etc.

[Wales99 in reply to Hidden]

She did a blood test. Full hormone screen.

[Hidden in reply to Wales99]

Okay thanks. I got my levels tested before I started HRT. I'm wondering if she would be able to test me again to see if I'm absorbing it... I'll ask her next Monday. That would make me feel better at least knowing if I'm on the right treatment or not

[Hidden in reply to Smithy999]

How long did it take for you to get relief from the hot flashes on your HRT patches? Because I've been on the generic Estradiol 0.075 mg patch and it is not helping my hot flashes at all and it's been 3 and 1/2 weeks. My doctor said that it might take a month but it's getting really close to that and I've not gotten any relief at all and most people act like they get relief within a couple weeks. I have an appointment with her in a week but she's already said that she's going to keep me on the same dosage for another month or so. Is there a way to check if I'm absorbing it? Should it be taking this long for it to kick in?

[Wales99 in reply to Hidden]

That’s so frustrating. I know what you mean when they say give it longer & you’re really suffering. My gynae said you should know if it’s working within 4 weeks but that is just her opinion. I really hope you get somewhere soon 😊.

[Hidden in reply to Wales99]

Thank you. I wish my doctor would just say give it 4 weeks and if it doesn't work then just do away with it all together because at this point I'm tired of waiting and I would rather either just go up to a 1 mg estradiol patch and see if that works or get off of it since I'm so worried already about if it's going to make me gain weight or not. It's like I just want to know now if it's not going to work Because if it's not going to work then I want to just go ahead and start trying supplements again like I've tried black cohosh but that was 80 mg a day for almost 3 months and that didn't help any either. So I was thinking about if this estrogen doesn't work then maybe I could try going on a higher dose of black cohosh or she suggested Estroven over the counter although that's very expensive as well and I was hoping this would be the most effective as it's generally works for most people but my insurance will only cover the generic patch or obviously the generic oral tablets. If it's going to work then I wish it would kick in already.

[Hidden in reply to Wales99]

I wish it wasn't like a 3-month limit like I wish they would just say if you don't get relief in 5 weeks then that means you're not absorbing it and you should either move up to a higher dosage or switch to a different form of HRT like it's like I don't like this whole thing of 3 months is that so far away. I'm hoping she won't make me do it for 3 months before she makes a change. I'm just wondering if I would absorb the pills better? Everyone here seems to act like the patches are so great or the gel or the spray but my insurance will only cover either this generic estradiol patch or the pills, so those are my only two options.

[Wales99 in reply to Hidden]

yes it is difficult. It sounds like you’re in USA. We have the NHS here in the UK & just have to pay a prescription charge of £9.00 to get medication. It is much harder in the USA from what I understand. Speak to your Dr & see what they think. You should be able to say what you want & make a joint decision I would have thought. Good luck 😊.

[Hidden in reply to Wales99]

Yes I am in the USA and so you only get what your insurance will pay for and with my insurance I either only get the generic brand of a Estradial patch or the generic Estradiol pills nothing else. Thank you for your advice and help I will talk to my doctor on Monday

[Wales99]

I’ve literally just started my first patch today. Davina McCall has videos on applying patches & gels. Also my GP directed me to a good website Menopause Matters. Also there is a good website Miss Menopausal which is quite lighthearted but has info on different types of HRT.

[Florrie2 in reply to Wales99]

Thanks. I’ve watched the videos on how to apply them on the Menopause Doctor website. I hadn’t found anything from women saying what it was actually like to use them daily. I’m a bit of a research junkie so I like to know as many facts as possible before making a decision or putting a case forward to a doctor. With my doctors surgery, I get a different doctor each time and cannot book a specific one so I need to be really confident in what I think would work best for me.I see the Menopause Matters site has a document with pros and cons of each type of HRT which is helpful.

Good luck with your patch 😀

[Wales99 in reply to Florrie2]

Yes I know what you mean. I like to know as much as possible too - forewarned is forearmed as they say! I’m really praying that this works for my daily migraines. Good luck with whatever you decide. 😊

[Peacelovelight]

I have been on oestrogen patches MX 75 for 10 years after a hysterectomy and would be interested to know what dosage others are on? Mine have now been reduced to MX 50 for the last three months and I feel awful. I can find no reason why they have had to be reduced?

[Florrie2 in reply to Peacelovelight]

This probably doesn’t help you but the patches I have been put on are 50mg oestrogen and 170mg progesterone. My surgeon wanted me on 100mg oestrogen but that’s another story and another post..

[Meno56]

I started on patches and hated them for all the same reasons others have said. Couldn't get rid of the black outlines without scrubbing. I now use the gel and although am testing higher doses, have decided to use in the morning which suits me better. If I want to take 3/4 pumps I'll use 2 in the morning and 2 at night instead of filling up arms and thighs! The process used to bug me at night as it delayed me getting into bed - first world problem I know, but these things get annoying. Rubbing the gel in well is best - refer Menopause Doctor and I find that it dries pretty quickly. Hope that helps.

[Florrie2 in reply to Meno56]

I’ve now been on Evorel Conti patches for just over a week and have found them much easier than I feared. One didn’t fully stick so was considering changing it - woke up in the morning and it was fully stuck down!

[HeartWoman]

It is so individual. If I use patches, then I feel like I get it all at once and get jittery fir a while zbd then nothing until time to change the patch. I tried gel and it didn't move my levels one bit, so i guess I didn't absorb it. I absorb the oral form, but gives me thyroid issues. I am trying compounded cream now, so hope it helps. There are so many variables in what works got each woman.

[DylanTheRabbit in reply to HeartWoman]

Hi HeartWoman, while I completely respect your individual choice regarding managing your health. I would like to point out that menopause experts are very concerned about the use of compounded menopause treatments. They are completely unregulated and may not provide enough progesterone to protect your uterus. There are many forms of HRT and there are regulated, body identical options available on the NHS.

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