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[GypsyRoseLee]

My GP insisted that the oestrogen dose in Femostan 1/10 was double the dose of oestrogen in my Estradot 50mg patch.

I don't think this can be true but can't find anything on Google that works out the ratio. Does anyone on here know?

[Milamam]

Hi GRL,
When I looked up Estradot it said the following:

2.5 cm2 patch containing 0.39 mg estradiol (as hemihydrate) with a release rate of 25 micrograms estradiol per 24 hours.

3.75 cm2 patch containing 0.585 mg estradiol (as hemihydrate) with a release rate of 37.5 micrograms estradiol per 24 hours.

5 cm2 patch containing 0.78 mg estradiol (as hemihydrate) with a release rate of 50 micrograms estradiol per 24 hours.

7.5 cm2 patch containing 1.17 mg estradiol (as hemihydrate) with a release rate of 75 micrograms estradiol per 24 hours.

10 cm2 patch containing 1.56 mg estradiol (as hemihydrate) with a release rate 100 micrograms estradiol per 24 hours.

https://www.medicines.org.uk/emcmobile/medicine/15649#COMPOSITION

Which means 50 patch is a bit less than Femoston 1/10. Femoston 1/10 contains 1mg of estradiol

[GypsyRoseLee]

Thank you so much for that Milamam.

I wondered if Femostan 1/10 had less than my 50mg patches because since I have been in Femostan I have been sleeping really badly again.

I feel nicely sleepy late evening, go to bed, then lie there still feeling sleepy but just cannot fall asleep. Eventually I start to feel more awake and then have a really poor night's sleep. More cat naping than real sleep. This has happened the last 3 nights in a row.

Then wake up really early, feeling really tired, but cannot get back to sleep.

[Milamam]

I find I sleep much better when I start the progesterone pills. Instead of low, I feel nicely relaxed and content, looking forward to good sleep. I hope dydrogesterone will work the same way for you!

[GypsyRoseLee]

It could be that my poor sleep coincided with my period starting too, I suppose? Though it usually only interferes with my sleep the night before it starts. Period seems to be finishing already so fingers crossed I will sleep better tonight.

I really hope the progesterone makes me feel calm and content too, that's been in very short supply these last 5 weeks.

[Briony]

When I asked my doctor, and on here, all responses said a 50 mcg patch can't be directly compared with a pill as the absorption rate is so much higher for a patch than a pill. Femeston 1/10 is classed as low dose hrt whereas a 50 mcg patch is a medium dose, suggesting the Femeston, overall, has less estrogen absorbed?

[Hurdity]

Absolutely Briony!

The total amount of oestrogen in the product is irrelevant, it's how it is absorbed and how much that is important.

I mean as Milamam says the 50 mcg patch contains 0.78 mg estradiol - but that is the total on the patch - it is the delivery rate that is important - and on average this is 50 mcg per day directly into the system. The actual amount will depend on the woman's physiology and her skin.

Also re the tabs/patches 50 mcg = 0.05 mg because 1000 mcg = 1 mg.

Much of tablet HRT is lost through digestion and then it is metabolised by the liver too.

The pharmacokinetics of all of this is very complex and depends on what is measured - average peak levels, or averaged over 24 hours for example - as well as there being huge inter and intra individual differences - ie different women absorb the different products differently from each other and achieve different estradiol levels as a result. I;ve tried to look into this several times but the measurements given are not easily comparable.

As Briony says - therefore, 1 mg Femoston is likely to achieve a lower oestrogen level than a 50 mcg patch - although it depends on how you personally absorb the products too.

Hurdity x

[GypsyRoseLee]

God it's complicated isn't it?

After 3 days on Femoston my sleep was poor, and I felt incredibly low and tearful on Monday night. Possibly as bad as I have ever felt since this nightmare peri all started. Infact I came so close to cancelling our NYE plans because the thought of socialising just filled me with genuine dread.

Then my period, only lasting 2 days, finished yesterday morning and by tea time I was feeling as right as rain again. Happy. Relaxed. Looking forward to NYE.

I just can't fathom it. If it was anyone else describing this I would think they were exaggerating so much. But I'm not. I'm really not.

I can only think my natural oestrogen is now rising, and combined with the 1/10 it's making me feel great. For now. But God only knows what will happen next for me?