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[Pippa52]

Hi all - I have been on Estradot 50 patches for the last month (having worked my way up from 25 - 37-5 to 50). I am finding they are only effective for 2 days then I get all the symptoms of hot flushes, headaches, anxiety, palpitations back.  Has anyone else had this problem?  I'm not too sure what to to but have been changing them every 2 1/2 days as otherwise the symptoms become unbearable. However am I giving myself too much of a dose this way?  I don't have another check up due till March so was just wondering whether what I am doing is ok/safe.  I used to use the gel and of course that was applied every day but I understood the patches had enough slow release oestrogen to last for 3/4 days. I have developed sore breasts so its clear the dose is getting through as on the gel I was not absorbing at all with a blood level of only 53pmol despite being on 2 pumps of Oestrogel.   xx

[VanillaLover]

Hi, I believe the patches work on the concentration gradient between oestrogen in the patch and that in the skin (which is why you should change areas when you put a new patch on as the skin under the patch will become saturated and not absorb any more).

So if your own oestrogen is very low, the patch oestrogen will diffuse quicker and hence will “run out” before it’s supposed to.

Also if your levels were very low before starting it may take a while for it all to balance out and get into an equilibrium…..so may be worth sticking with the 50 for a bit longer until your review?

Depends how bad you are finding your symptoms whether you can wait and see if it settles down but if not I think it would be safer to go up to next doseage patch rather than change more often?

[Pippa52]

VanillaLover - thank you so much for your reply.  I so agree with what you say it makes perfect sense re the patches working on the concentration gradient between oestrogen in the patch and that in the skin. My level was uber low and  I had a total hysterectomy many years ago and was on Oestrogel for over 20 years until the shortages and never had a problem at all but since I had to change it has been an ongoing nightmare for a year and a half but I do feel that the Estradot will work for me in time as sadly the slightly changed Oestrogel formulation stopped absorbing at all for me.  I have actually telephoned to ask for some more advice and am getting a phone call back next week so hopefully then I can know exactly what I should be doing.  I suspect you are also right that maybe I need to go up a patch in strength but at least I will know the way forward.  Thanks again so much for your reply really appreciate your advice and knowledge.  xx

[Clarella]

My Gp said some women over lap the patches - on higher doses I’ve found that too much but iirc I did for a few hours on the lower doses. Obviously it’s an “up” and a “down” but might up you a bit more initially to carry you over if that makes sense.

I do think I found it wearing off by day 3 initally (I change each 3 days) but after 3 months I do think It’s better and can do 3.5 days.

I’ve read of someone here who used two 50s and changed a different one each 2 days as was having similar issues.

I howl it resolves for you soon x

[Pippa52]

Mollydolly - you are spot on.  I actually had a telephone consultation this morning as there had been a cancellation and the Consultant told me to do just that - increase my dose - eventually up to the 75 patch.  Like you I will increase it by 12.5 or half a 25 patch on top of the 50 patch as I am uber sensitive to dose increases or decreases.  The consultant said she would be fine with it if I needed to change the patch every 3 days rather than 3 and then 4 if the new dose still did not last for 4 days.  Thanks so much for your post - really appreciate it. Yes I find heat or hot baths definitely speed up the uptake of the oestrogen in the patch too. xx

[Pippa52]

Clarella thanks so  much for your post.  That's so good to know that you are now up to 3.5 days - as you say it does take time for us to adjust to the dose.  The consultant told me to increase my dose which I will do slowly as she said if you have a higher baseline of dose it should see you through longer than my present dose does so tomorrow I will add half a 25 patch to my 50 and eventually if needed go up to a 75 patch.  All trial and error but I am sure we will get there in the end.  Thanks again for your post xx

[Clarella]

Sorry I never replied - how are you all?

I’m now on 125 patches and have just decided to change every 3 days for consistency. I find it easier to do it/ remember in the morning and am still sometimes noticing dips. Or the impact of the new patch at night if that makes sense. I have to take inhalers and thyroxine too so it’s just easier!

Only time for now I may extend is if if I go for a sauna! I think I’ll take the patch off before and reapply.

I’ve not yet ever been at a consistent stable level of everything for a decent period of time but hoping to now, going forward. (A string of viruses, chest infections and covid has plagued me since Xmas too; I’ve not known what symptom is caused by them or meno!)

It means a box lasts for 24 days rather than 28 but I’m fine with that.

[LSmarty]

Clarella
Was it a private doc that prescribed the 125 patch?
I'm on 100 but desperate for more, my doc just keeps saying 100 is the highest although I know that's not right, I'm very frustrated

Les xox

[sheila99]

Clarella
Was it a private doc that prescribed the 125 patch?
I'm on 100 but desperate for more, my doc just keeps saying 100 is the highest although I know that's not right, I'm very frustrated

Les xox

This seems to be the guidelines for many gps. If they won't prescribe more you can ask for a referral to an NHS meno clinic where specialists can increase it.

[LSmarty]

Sheila99

I used to attend the hospital and was prescribed more many moon ago.... My doc liases with them now and she said they said they won't go any higher. Tfb I need to lose weight but would this be enough to not get a higher dose?

Les xox

[Gilla999]

Just wanted to follow up on this really interesting thread. I swapped over from Lenzetto to Estradot patches about 4 weeks ago - initially on a 25mg patch and then increased to a 37.5mg patch. I have been feeling like the patch is only lasting for two days, and then I seem to get a reoccurrence of the depression / low / tired feelings and also a return of the palpitations. I tried increasing to a 50mg patch but that was a disaster and triggered off the current autoimmune/allergic condition that I'm battling with and which seems to be triggered by a rise in Estrogen. I felt better in that sense once I dropped back to a 37.5mg patch, however I really do feel like it only seems to last for 48 hours. I should add that I have a boiling hot bath everything evening - I know that's not supposed to make any difference, but was interested to see what Molly said with her experience about that.

I definitely feel much more of a sense of "peaks and troughs" with the patches than I did with Lenzetto, which is strange as I know it's supposed to be the opposite!

Found it really interesting that I'm not the only one experiencing the need to change it earlier than stated

[Pippa52]

Gilla999.... I have only just this last week managed to get to the 3 days but there is no way I can make 4 days.  I was changing the patches every 2 1/2 days and since posting have heard from other ladies on here who also change the patch every 3 days or sometimes 2 days if they go swimming etc. My Meno consultant told me that she was happy with a 3 day patch change regime.  I had heard that hot baths may have an effect on patches or heat like an electric blanket can increase the rate at which the oestrogen is absorbed. I am on 68 now and changed patch yesterday and feel quite hyper plus a headache today (one week in on higher dose) so am hoping that it calms down soon.  Patches are supposed to produce a level dose throughout the days but I always notice quite a boost some hours and the day after a new patch day.  I guess with Lenzetto or Oestrogel it is being replenished every 24 hours so maybe suits some people better than the patches. The roller coaster continues   Hope so much you continue to improve on the 50 patch fingers tightly crossed for you xxx

[Wrensong]

On the heat issue, Poppytoast, Gilla, Pippa - agreed, there's said to be something called oestrogen dumping that occurs when patches get overheated.  Some years ago I was advised to remove my patch before MRI & when I asked why (MRI was head & neck, patch on butt, so seemed odd to me), Radiology said because patches may get super heated during MRI, causing them to release excessive amounts of oestrogen . . . affecting symptoms.  Can't find any studies to back this up today, but would be interested if anyone knows of any.

For that reason I take care not to allow my very hot shower water to blast my patch directly, though hot water still runs over it of course.   Might be worth experimenting Gilla, if you can swap the v hot bath for a shower that gives you a bit more control over heat potentially affecting patch release.
Wx

[Gilla999]

Pippa and Wrensong, thank you so much - that is so interesting and helpful! At the very least there can't be any harm in experimenting with showers and a 2 day patch change - if it doesn't make any difference then no harm done and I can look at other causes. Thanks again for your replies, really helpful xxxx

[Wrensong]

I hope it helps, Gilla.
Wx