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[MicheleMaBelle]

Hi ladies. I'm a bit confused re these patches and dosage. I've happily (? )been on Estraderm patches and 10 days of Utrogestan for a couple of years. Couldn't get the patches and was changed to Estradot a couple of months ago. Now can't get these and pharmacy is trying to get my GP to prescribe Progynova.
I've just had a look at online leaflet and it says to only use the patches for 3 weeks out of every 4 if you're on GAP treatment. What on Earth is GAP treatment? Do they mean sequential treatment and if so, why is this different to the other patches where you have continuous oestrogen and take progesterone for part of the month?
I'm confused...

[Dancinggirl]

I suspect they may be used for contraceptive??!! Hence the GAP reference.  Have you tried using Oestrogel as an alternative to oestrogen patches - this might be you best option until the oestrogen patches are available again. DG x

[Hurdity]

Hi MicheleMaBelle - I had a quick look at the product info on this and the instructions are weird because it refers to cyclical and continual use of the patches in terms of either 3 weeks or 4 weeks of oestrogen and then later refers to the cyclical use of progestogens! Be assured that you can use it just like any other patch ie continuously.

Here is the info:

4.2 Posology and method of administration

Posology

Progynova TS 100 is an oestrogen-only patch applied to the skin once weekly.

For initiation and continuation of treatment of postmenopausal symptoms, the lowest effective dose for the shortest duration (see also Section 4.4) should be used. Treatment to control menopausal symptoms should be initiated with the lowest Progynova TS patch dose. If considered necessary, a higher dosed patch should be used. Once treatment is established the lowest effective dose patch necessary for relief of symptoms should be used.

For prevention of postmenopausal osteoporosis Progynova TS 50 is recommended. Women receiving Progynova TS 100 for postmenopausal symptoms can continue at this dose.

In women with an intact uterus, a progestogen should be added to Progynova TS 100 for at least 12-14 days each month. Unless there is a previous diagnosis of endometriosis, it is not recommended to add a progestogen in hysterectomised women.

For continuous use:

The patches should be applied once weekly on a continuous basis, each used patch being removed after 7 days and a fresh patch applied to a different site.

For cyclical use:

The patches may also be prescribed on a cyclical basis. Where this is the preferred option, the patches should be applied weekly for 3 consecutive weeks followed by a 7 day interval, without a patch being applied, before the next course.

https://www.medicines.org.uk/emc/product/6263/smpc

Maybe it is an old-fashioned HRT and this is how it used to be given in the same way as contraceptives as Dancinggirl suggests?

Hurdity  x

[MicheleMaBelle]

Thanks Hurdity. Makes you want to weep😭
Dancing Girl- it's my last resort but didn't get on with Oestrogel at all. Brought me out in the most terrible rash 😵x

[Tc]

Michele.
I've just been changed to the progynova ts100 patch. From estradot. Like you it was my only option as I dont get on with the gel

I hadn't heard of it before either  and also wonder if it is an older patch hurdity. .

My leaflet which came in the packet  (last revised July 2018)  also mentions the 7 day gap to allow for a bleed??. As you say like contraception but it states on my leaflet it should only be used by women who are post menopause.
Bit odd!!! .

 But it  does seem it can be used continuously too. It is the same active ingredient as estradot. There is more of it per  patch than in the 100  estradot but my pharmasist assured me that's because it is change once a week whereas estradot is twice  and that the  daily delivery idose s the same.

I've switched to it today.  although I was on 200 estradot I thought it might be best to start the new patch at 100 in case I absorb it better  bit worried if I've done the right thing by lowering realy.

I hope you get on okay with it.

Let us know how you get on. I will report back too if you like and we can compare notes!!!

Xx

[MicheleMaBelle]

Thanks TC. Haven't picked up from the chemist yet but I've still got a months supply of estradot left. Not sure if I've got on with the bigger dose ( 75mcg ) estradot so I've asked to go back to 50mcg  on the new ones. I'm fed up with all of this. I've a friend who lives in Spain part of the year. I'm going to ask her if she can check what's available to buy over the counter and bring me some back.
On the other hand, I'm thinking of coming off it to see how it goes when I come back from holiday x

[bear]

Hi girls,

These old links might explain why Progynova TS leaflet still refers to 'oestrogen cycling', an option that has been considered in the past for HRT in menopause:

https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/j.1479-828X.2001.tb01328.x
https://www.sciencedirect.com/science/article/abs/pii/S0378512297000674

And more recently for Premature Ovarian Insufficiency:

https://academic.oup.com/hropen/article/2017/2/hox007/3957909

Nothing to worry about, then. Hope this helps.

BeaR

[Tc]

Thanks bear. Xx