Menopause/HRT Question.

[Sparklingsunshine]

I recently changed over to the Evorel 50 HRT patches from oral HRT tablets, well what a waste of time, they are absolutely useless. They wont stay on even though I put a sticky plaster and surgical tape on over the top. I used 4 in a week!

They are definitely not for me. I had a consult today with a GP to discuss options. She asked if I'd ever come of HRT altogether? No. I was told you cant stay on it indefinitely. One thing I noticed with the patches was feeling hot and flushed in the evening.

I was a bit surprised as I was under the impression the health benefits outweighed the disadvantages. Do other members know about this?

She also said they hardly ever prescribe oral HRT, as its all transdermal these days. I feel well on my tablets and have never had issues, so I'm rather surprised I've never been reviewed and asked to change. Been on mine for over 7 years.

Quite honestly I'm tempted to stick with tried and trusted rather than try yet another form of HRT. I'm nervous about having something else that might not suit and then trying to get an appointment to change back. Wish I'd kept my mouth shut 😒

[Buddy195 Administrator]

I also found patches came off SS so moved to oestrogel.

[Sparklingsunshine in reply to Buddy195]

Thanks, how do you get on with it? I'm rather reluctant to keep trying new things especially as getting to speak to a GP is so difficult. I like my tablets and didnt realise they were frowned upon. Also have you been told you need to come off HRT?

[Buddy195 Administrator in reply to Sparklingsunshine]

I’m much better on the gel. I wasn’t offered tablets so can’t comment on them. I’ve been taking HRT for 2 years and don’t see a reason to stop as still get flushes if try to reduce oestrogel.

[Supanova91 in reply to Sparklingsunshine]

I would stay on them yes the health benefits far out weigh the risks. I follow Dr. Louise Newson and she is a menopause specialist and knows what she is talking about. ( in my opinion anyway )

[BiscuitBaby]

HiI just started hrt and have the same patches as you. I'm OK with them but my friend couldn't get them to stick either. She changed brand and found them to be better. I think it's trial and error and you might be better with gel or spray?

[Sparklingsunshine in reply to BiscuitBaby]

Glad its not just me 😁. I find oral HRT suits me and its less of a faff than gels or remembering to change patches.

[TiggerMe Ambassador in reply to Sparklingsunshine]

The spray dries within a minute 🤗

[Star13]

Not being too personal but where are you putting them? I’ve used patches (not your brand) for many many years and only had an issue if they are in a spot that rubs with clothes. You might want to try repositioning them before you give up.

[Sparklingsunshine in reply to Star13]

I've tried both thighs and calf and they fell off. I exercise a lot and am a sweaty Betty, which I explained to the GP before she prescribed them. But if they wont stay put, even with a plaster over the top then they arent really fit for purpose.

I cant imagine swimming with one or using a sauna. And pretty much anywhere you put them will be in contact with clothes that can rub. Except your face, which isnt a good look 😆

[FancyPants54 in reply to Sparklingsunshine]

They will be fine with other types of skin. It's not that they are not fit for purpose, but the glue on that brand doesn't suit you. When I used patches I cleaned the skin first with surgical spirit so that there wasn't a speck of oil on me. And I covered the patch with a surgical dressing, not tape or a plaster, it was invisible and worked very well. But you don't want them on your calf. Put them on your backside, or lower back, or lower stomach.

[Star13 in reply to Sparklingsunshine]

I’ve used patches since I was 42 and I’m 72 now! I’ve always put them on my lower hip/butt area at top of leg as it’s the least likely to come into contact with either your pants waist or leg elastic. Put your pants on and look in the mirror as to where would be the best place to put the patch where it won’t touch any edges and likely curl an edge.

I’ve used them , swimming and exercise and if anything I get fed up with the gunk left behind! I don’t think you sweat at the top of your hips/glutes!

[Sparklingsunshine in reply to Star13]

I do, I sweat heavily during exercise, one of the many joys of Fibro. I have to take meds to help control it. Its worse since I've been on Venlafaxine for migraine. Anti D's tend to increase sweating.

[FancyPants54]

If you get on well with tablets, say you want to stick with them. Don't mess with it if it's not broken is my view. Are they the modern tablet type, not the older Premarin?

There is no need to come of HRT ever. Most of us intend not to do so. GPs knowledge of HRT and menopause is often stuck in the past.

I use a mix. I have 2 sprays of Lenzetto spray oestrogen and a Bijuve capsule which is the first combined capsule to contain body identical oestrogen and progesterone. The mix suits me well.

The best place to get up to the minute advice in podcasts, videos, written booklets and web pages is balance-menopause.com

It's the Louise Newson Clinic information and is the fullest and most informative I've found. They run GP training courses. Perhaps you should print off info about it and drop it into the practice manager at your surgery. Drop a big hint that they need to be more up to date.

The reason HRT has moved to transdermal in the main these days is that there is no risk of clot, and therefore stroke, with it. There is more of a risk for these things with tablet HRT.

You will find information about all the types available on the balance web site. But briefly there is gel, spray and patch and many varieties of patch. I have used Estrodot and they stuck well for me. If the pats comes off, lifts at the edges or crumples up you won't be getting a full dose and so symptoms will creep back as you have found. Also skin absorption is different on different areas of our body and different between women.

[Sparklingsunshine in reply to FancyPants54]

I use Femoston conti which I've used for 7years. I did research it quite a bit and it suits me. I'm assuming its a newish one. I thought her comment about coming off HRT was odd as I've heard several members say they intend using it indefinitely. She was a locum so not connected with my surgery.

As I've mentioned I use the gym several times a week and the combination of being hot, sweaty and tight fitting clothing means I dont think the patches are a viable option for me. Thank you for your input 😊

[FancyPants54 in reply to Sparklingsunshine]

Yes that is a modern HRT tablet. Still slightly more risk of clot than through the skin but you are keeping fit and active so that's less risk in it's own right.

[Sparklingsunshine in reply to FancyPants54]

Well I dont drink or smoke, I'm a healthy weight and eat healthily so doing my best. Never had high BP so I hope I'm low risk. How do you find the Bijuve tablet? I was interested in that as well?

[FancyPants54 in reply to Sparklingsunshine]

I love it!

My problem is that I don't absorb very well through the skin. I seem to have very fluctuating absorption, probably due to my still (many years) not balanced thyroid problem. My skin is very dry and flaky in places. And so I got very varied results from transdermal.

Gel - Specifically Oestrogel, would hit my system like a shot of caffein and I would be running with sweat, especially my hair, and I'd be anxious just as I finished getting washed and dressed in the morning! And then by evening I would feel it wear off suddenly and I'd flop. I tried it for a few years at varying doses but could not make it work. Interestingly Sandrena gel did not do that to me. I preferred it but as it comes in 1mg sachets it wasn't so easy to vary.

Then I tried the patches and again my biggest issue with them was a fresh patch would hit my system, but I'd be dragging towards change day, really needing a new patch every couple of days. But then it would build up and I'd be over-dosed feeling. I remember driving once, on a fast road, wearing jeans with my patch on my bum, but so desperate was I to get it off me that I managed it mid journey. And then I'd feel calmer quite quickly.

After that I tried Lenzetto spray. I like that and seem to absorb it well. It's not very strong though so I needed to put something else with it or my levels were too low (other women can get enough from Lenzetto on it's own, again I think it's down to the condition of my skin that I just didn't get full benefit). So then we tried Bijuve not long after it came into the UK formulary and with 2 sprays of Lenzetto a day (spray am and capsule pm) I feel HRT is finally good and level. I had my HRT specialist review last week. She pointed out to me that I could be considered to be using too much oestrogen for the 100 ml progesterone, but as I then pointed out, you are only ever told to take 100 ml capsule of Utrogestan whatever your oestrogen level. She agreed, said she wanted to make sure I could argue my case with a GP if ever asked.

[Sparklingsunshine]

Its like anything isnt it, risk vs benefit. Rather like doctors lecturing us on the evils of T3. Its a balance between quality of life now and a possible problem down the line 😄.

Maybe I'm unduly influenced by the experiences of many members of my family who reached a ripe old age but whose quality of life was non existent ( their words) and who basically had had enough and wanted to die.

Seeing what they suffered has maybe made me far more focused on having a better quality of life, albeit potentially shorter, rather than a long drawn out gradual decay and deterioration. Just my opinion of course.