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[Hetty2018]

Hi ladies
Was just wondering if any of you have heard this theory of high absorption rates if you are in hotter climates ?
I had a total hysterectomy 2 years ago and have so far tried 4 different hrt regimes .. I'm now on 100 Evorel patches, 2 weeks after starting with the patches I went on holiday to Spain and I felt amazing.. all of my horrible symptoms went and I felt like the old me.. however when I returned I went back to how I was.. my bloods have shown a change in my levels that went from <100 even when I was using 4 pumps of estrogel and is now sitting at 180 with the patches.
I've just read on the menopause doctor Instagram page (Louise Newson) that patches will have a higher absorption rate in hotter climates so I'm wondering if this is why I had no symptoms whilst in Spain.. that I was absorbing the correct amount ?
Any help would be greatly appreciated xxxxx

[Hurdity]

Hi Hetty2018

If you think that to get a patch to adhere to your skin you need to use a warm palm - then the glue is likely to stick better the warmer it gets, up to a certain temperature when the estradiol could be deactivated? One study I read showed absorption was always higher in the evenings from 3 different types of patch https://www.maturitas.org/article/S0378-5122(99)00039-0/abstract. I think our body temp is higher in the evenings and lowest in the mornings? From what I recall from reading another study a while back (sorry don't have the ref) this was due to blood vessels in the skin. In the same way, when we get hot generally, the blood vessels in the skin dilate to help us lose heat and therefore presumably also are more able to transport the estradiol quickly? Does that make sense?

However serum blood tests are pretty inaccurate as they are so variable (according to time of day and temperature too) so it is how you feel that is the main thing, so if you felt amazing, aside from the fact that you were enjoying yourself on holiday in good weather - then that could be also contributing (estradiol absorption....). The "correct amount" is the dose you need in your normal environment to feel well most of the time - and this is incredibly variable amongst different women, so if you don't feel well at your current dose - then maybe go for a slightly higher dose or chnage a bit more often ( eg try every 3 days instead of 3.5?). 100 mcg is theoretically a high dose per se but if you're not absorbing then it's not a high dose for you. A series of blood tests can be helpful but one or two not so much. Also if you kept your ovaries then you may well still be peri-menopausal?

Hurdity x

[Hetty2018]

Thanks Huridity
That's really useful .. although slightly in panic mode now that my evorel 100 are out of stock anyway and I've got to try and find an alternative as my GP isn't the best 🙄 and I've been waiting 4 months for the appt for the menopause clinic too 😫😫😫
Ps I had a total hysterectomy so no ovaries  x x


quote author=Hurdity link=topic=44580.msg716731#msg716731 date=1564568700]
Hi Hetty2018

If you think that to get a patch to adhere to your skin you need to use a warm palm - then the glue is likely to stick better the warmer it gets, up to a certain temperature when the estradiol could be deactivated? One study I read showed absorption was always higher in the evenings from 3 different types of patch https://www.maturitas.org/article/S0378-5122(99)00039-0/abstract. I think our body temp is higher in the evenings and lowest in the mornings? From what I recall from reading another study a while back (sorry don't have the ref) this was due to blood vessels in the skin. In the same way, when we get hot generally, the blood vessels in the skin dilate to help us lose heat and therefore presumably also are more able to transport the estradiol quickly? Does that make sense?

However serum blood tests are pretty inaccurate as they are so variable (according to time of day and temperature too) so it is how you feel that is the main thing, so if you felt amazing, aside from the fact that you were enjoying yourself on holiday in good weather - then that could be also contributing (estradiol absorption....). The "correct amount" is the dose you need in your normal environment to feel well most of the time - and this is incredibly variable amongst different women, so if you don't feel well at your current dose - then maybe go for a slightly higher dose or chnage a bit more often ( eg try every 3 days instead of 3.5?). 100 mcg is theoretically a high dose per se but if you're not absorbing then it's not a high dose for you. A series of blood tests can be helpful but one or two not so much. Also if you kept your ovaries then you may well still be peri-menopausal?

Hurdity x
[/quote]

[Hurdity]

Hi Hetty2018

OK - re ovaries - then you will want to make especially sure you are able to continue with the right dose. (Btw total hysterectomy - ovaries may or may not be taken which can be a separate op - BSO (bilateral salpingo....etc). Total hyster = womb and cervix hence my asking!).

All the other patches are listed here: https://www.menopausematters.co.uk/treatafter.php (scroll down). You will see that there are 4 other types.

Good luck with finding a substitute and also with the meno clinic!

Hurdity x