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[Holsy]

Has anyone suddenly stopped absorbing from patches after being on them for a long period? If so, do you have an answer as to why it has occurred?
I have been on hrt (Evorel 50) for 5 years, with mirena coil, since 2008 for fibroids. I had my coil replaced in March 24, shortly after I started to get all of my meno symptoms back again. GP thought the progesterone in the coil had probably unbalanced hormone levels, so I started to take Lenzetto once a day too. After 6 months I stopped Lenzetto but soon felt like I was back to square one before taking hrt. I felt dreadful, all meno symptoms back. My estrogen levels were 419 in 2019, now down to 45. I felt like I had gone cold turkey. GP put me on Estradot 50, to try a different patch, levels went up to 71 after 5 weeks, so GP put me on Estradot 75, levels were 82 after another 5 weeks. I was still feeling dreadful. GP has no idea why I would suddenly stop absorbing from the patches, my diet and weight hasn't changed. I have tried putting them on different parts of my body, but no absorption. GP has now prescribed the gel which I'm trying on my inner thighs, but concerned about not absorbing this either. Or that it will work for a few years and then stop again. If anyone has been through the same and has any reasons for this I'd love to hear from you, sorry if this has been covered but I couldn't find anyone who had stopped absorbing after being ok for so long.

[CLKD]

Gel and patches to rebalance?  How au fait does your GP appear or is he/she grabbing at straws?  There are menopause clinics with waiting lists in both NHS and private sector.

[Holsy]

My GP is good actually. She knows I don't really want to take tablets either. She has sent me for a testosterone blood test.

[Holsy]

Sorry I also meant to say that she thought I was getting too much progesterone from the coil as it does release more in the early days of having it fitted, so I had more progesterone than estrogen. I did start to feel a little better taking the Lenzetto.

[CLKD]

Will U B able to continue with that for a while?  R blood tests reliable?

[Holsy]

I will stay on the gel for a while to see if I start to feel back to normal and the majority of the symptoms start to ease too. The bloods have been a good indicator, but I have been going by how I feel and the symptoms easing too. The symptoms all coming back have coincided with my oestrogen levels being low too. I'm just concerned about why I suddenly stopped absorbing from the patches after 5 years as I don't want that to happen again on the gel. Hence the initial query to see if anyone has had the same happen to them, but also found a reason why.

[CLKD]

Let us know how you get on?

[Wrensong]

Hi Holsy, I've also had increasing probs with absorption from patches as I've aged (now early 60s) & there are various possible reasons for this. I don't know whether you've seen this thread of Bombsh3ll's, but the paper she links to makes for interesting reading.

https://www.menopausematters.co.uk/forum/index.php/topic,71652.msg967011.html#msg967011

Hope the gel works out to be better for you.

[bombsh3ll]

I don't know your age but is it possible that you were not fully menopausal when you went on it and that some of the estrogen in your bloodstream in 2019 was endogenous?

Neither the lenzetto nor a 50mcg patch is a very high dose, and it is common for a particular regime to be adequate in perimenopause, then to need more as your own estrogen production wanes.

You may just find that using more does the job.

I would also say that if you can't get optimised on transdermal, don't fear oral estradiol.

I will only ever take oral unless I am 97 and getting a bed bath twice a week, as patches (used for IVF) never stuck to me for more than half a day, and I don't want the mess, hassle and unreliability of gel.

The thrombotic risk is numerically minuscule in healthy women without risk factors.

[Holsy]

Hi Wrensong, thanks for the link to the paper, I hadn't seen that thread. It is an interesting paper thank you and I will probably request a higher dose on the back of that. Although I did try Estradot 75 for 6 weeks and it didn't make much difference. Perhaps I needed to be on them for longer.

The gel appears better at the moment but do think 3 pumps (75) will be better. Although it is a faff, I much prefer the patches.

Hope you find a solution to your absorption issues.

[Holsy]

Hi Bombsh3ll

I have just turned 55, but think I was perimenopausal well before it was diagnosed. I was fobbed off with anti depressants until I found a better GP. I had an ovary removed, due to a cyst, when I was 35 and didn't even think about the loss of estrogen, neither did the GP at the time. I suspect I've had some perimenopausal issues since then.

Due to having the mirena coil it's hard to know what stage I was at when I started HRT, but I had all of the symptoms possible. I was on my knees. As I've just mentioned to Wrensong, I have read that paper that was originally posted by yourself, so I will request a higher dose.

I am just frustrated that I have been coping well on the patches for 5 years, so it's really annoying that they no longer work, unless I try 100 dose. The gel is a hassle, what do you mean about the unreliability of it?

Oral estradiol will be my next call if this doesn't work. Sorry that the patches didn't stick to you, but happy for you if the tablet is working for you though. I can imagine that the tablet will also be a faff finding the right dose again too. 

Thanks to everyone for your replies. Means a lot.

[bombsh3ll]

I've never actually used gel, but regarding unreliability I mean the potential for user error, having to measure it out, where to rub it, how thinly to spread it, how long to wait for it to dry and the likelihood that at least some of your dose ends up on clothes or bedding, and what happens if you sweat or wash within a given time after it.

Also it peaks really quickly and drops off, so blood tests aren't very reliable.

Oral estradiol is less static than a patch but a lot more even than gels. There is some good research by professor John Stevenson involving blood levels of oral estradiol, and if it's good enough for him it's good enough for me. My own blood levels are remarkably consistent on Zoely.

With a pill you just swallow it, takes a second, nothing to think about and no restrictions on when you can wash, exercise, swim, get dressed etc.

I also only ever know what day of the week it is because it's on my pill which I take first thing 😉

[Wrensong]

Holsy, if your skin has become drier with age, that's one of the factors than can hinder absorption from patches & I think might be the issue/one of them with me.  I see you have only one ovary - I have none, so missing a major source of testosterone which is involved in the production of sebum, helping to prevent skin drying out.  The levonorgestrel in your Mirena is an androgenic progestogen though, so hopefully dry skin is not an issue for you.

I have never had any probs with adhesion of patches, in fact they stick so well that it feels as though a couple of layers of skin come off when the patch does  .  Ouch!

[Holsy]

Hi Wrensong, my skin hasn't become drier on the areas where I applied the patches, nothing obvious seems to have changed, which is why it's hard to understand. Like you, they stuck that well that it was hard to peel them off too. 😂

That's interesting re: lack of ovaries and testosterone, wish we were educated on things like this from a younger age. I am scheduled to have a testosterone test in a couple of weeks, so will be interesting to see what the results show.

[Holsy]

Sorry CLKD I have just seen your response in amongst the others. I will certainly post an update once I have all of the results and any further answers etc. Thank you.