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[weathergirl]

I'm on the lowest patch (0.025) and wondering if others place their patches in other spots besides the abdomen and the upper buttocks? 

I ask because I have read (a while back) in some threads (not this forum) of women using the patches on their upper arm, their outer thigh, even the lower back area.   I would think the more sites for rotation, the better, in terms of not burning out receptors at regular sites.   I'm more curious than anything.  I know they are 'approved' for use on lower abdomen and buttocks, but I am curious why other sites are not used or considered.  I've often wondered if the testing was done at those sites (manufacturer absorption testing) and yet really many other body areas would be useful for patch placement as well. 

Any thoughts?  I'm not planning on going "off label" with mine anytime soon, but this has been a long-time curiosity of mine! 

[Hurdity]

I think for consistency the patch should be placed on approx the same type of area therefore if buttocks - then alternate these, ditto if you decide front abdomen. I think there have been studies looking into this and certainly I remember from Intrinsa testosterone patches the absorption on buttocks vs abdomen was different. This does stand to reason because the skin at various sites will have different thickness and fat layers and therefore different permeability - so keeping to approx the same part of the body will achieve greater consistency if you are sensitive to slight variation in systemic levels.

I don't think there is any question of "burning out receptors" - do you have any further information?

This is from my go to paper on the absorption of the different types of HRT (Kuhl 2005)

"Whether administered by means of a patch or
gel, estradiol diffuses through the stratum corneum,
epidermis and dermis, where it penetrates
into the blood capillary system. The continuous
estrogen flow is caused by a concentration
gradient between the application site and the
capillary vessels. The metabolism of estradiol in
the skin is low and the serum levels of estrone are
similar to those of estradiol. In contrast to the oral treatment with estradiol, there is no accumulation
of estrogens or estrogen conjugates in blood."

Personally I definitely would not use on upper body. Yes I am sure other sites would work - did someone on here say they put it near their ankles?

Hurdity x

[weathergirl]

I have rotated application around my hips, abdomen and buttocks and feel no noticeable difference with any one site.  I think I'm one of those women who is not very sensitive to fluctuations in levels, as mine very gradually dropped off during peri.  I am not suffering from any marked menopausal symptoms and that's why I'm using the lowest dose patch available.   

As for receptor burnout, hmmm, I do not have a specific site.  This was info I read in on a site about compounded bioidenticals maybe last year.  I just remember it really stuck with me (no pun intended) as it was speculated that repeated application to the same skin sites (even with some rotation) over time, could cause the skin receptors to not respond as well. I wish I had saved the link but like the zillions of things I've read about hormones and menopause online over the years, it is just one of the many that left a kernel of info in my head!

As I am likely not going to remain on HRT too much longer the patch placement issue is more of a point of curiosity to me than anything else.  Thanks for the input Hurdity and Hasty!

[Hurdity]

Ah thanks weathergirl - I am often the same - certain bits of info stick in my head but couldn't tell you where they came from. However...... if this information came from a site about compounded hormones - which itself is not a method that is sanctioned either in US or UK - I would be inclined to take less notice of it. I mean if this were how it worked surely we would all know about it and medical instructions etc would take account of it, and there should be scientific evidence? I agree though there will have been studies on placement sites. The whole subject area of oestrogen receptors is an interesting one!

Sorry I can't remember why you are thinking of stopping HRT?

Hurdity x

[weathergirl]

Hurdity, you are right that if receptor site 'burnout' were a serious issue, we'd likely know about it by now! There is a lot of seemingly valid info  (i.e. practitioner reports seeing such-and-such with so many of they clients) that is really just anecdotal info, so I apologize for not investigating further before throwing that thought out there.

To answer your question, I am fortunate in that I've experienced very few meno symptoms and would like to see how my body does without any intervention. The bottom line is I'm not 100% comfortable with the idea of long-term use, so I'd rather try it without. I've dropped down to very low dose for about 6 months now, (HRT, as a whole, for just over 2 years) so will gradually taper and go off maybe in the fall. Will use local treatment as needed if VA becomes an issue.

Hoping for the best. Guess that's really all we can do as well as good self-care on all fronts.    You sound like you have a very well-rounded approach and I'm trying to do the same!

[Hurdity]

Hey don't apologise - I'm just interested in any additional info out there as I don't spend all my time esp in summer sitting at my computer looking up research studies - so anyone that's got stuff I haven't come across - I'd love to know!  .

It will be interesting to see how you fare off HRT weathergirl - sorry I can't remember how old you are (I'm pathetic at remembering everyone's story!). I could use the excuse of my age.....

Hurdity x

[weathergirl]

Hurdity, I'll be 51 very sooon.  Agree with you about research. I spent so much time the year before doing research on meno and HRT and it became overwhelming. Eventually came to the point where I wasn't seeing anything 'new.'  My life is so busy and it's good to stay up to date, but there are so many other things to do!