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[Anglichanka]

hello all, I've seen a couple of threads about suddenly experiencing poor absorption but it seemed to be with very low doses of oestrogen. I've been on 200 estradot for years and was stable (yes, it's a high dose but it was adjusted according to symptoms at the Newson Clinic, and it suited me, and I get regular scans to check my endometrium).

Anyway with the shortage I was switched to Evorel, which crinkled and fell off and I immediately experienced all the usual symptoms of low oestrogen: my skin began peeling off my hands, and my mood was appalling: constant crying, anhedonia and the rest. I asked to be switched to oestrogel and thought that helped, but it didn't.

Finally I found a private source of estradot and bought a few months' supply. I assumed that would fix everything, but it hasn't. Still horribly depressed, still got peeling skin. I could usually guarantee that Saturday would be a good mood day, because it was new patches day, but it's Saturday and I've already been sobbing.

Obviously I don't absorb oestrogen very well, hence the high dose, but why would I suddenly not absorb estradot after so many years? The only thing that changed was the switch to Evorel. Could that have destabilised me to this extent?

All thoughts and advice welcome. (But please don't scold me for being on over-NICE-max-dose, I know.)

[Konijntje]

Just a thought: I’m not sure what “private source” means, as I’m not in the UK, but are you sure you got the right product? As in not a possibility that it is expired, counterfeit or been stored very hot?

Other then that, when did you start again on the estradot? Maybe you need a bit longer, but I’d expect to see a change very soon if you were doing fine on it before.

[Anglichanka]

Good question: I got it from a woman who is on the menopause matters group on FB. I trust her, and it's definitely the right product and she sent me the receipt. I started on it two weeks ago I think.

[Konijntje]

Ah, yes, then it’s probably the right product. I too, would expect you to notice a difference after 2 weeks, it’s not like you’ve been off hrt in the meantime. If you think you hardly absorbed any estrogen before, maybe it could take a bit longer to feel better again on the correct dosage, but I’m not an expert of course. I do know the “stay on a regimen for 3 months” makes sense (I’ve tried quite a few things, not all of those for 3 months), so if you look at it from that perspective, 2 weeks is quite short.

[ChloeX]

I am also having problems with Estradot having been settled on the 100 patch for years. Since the shortages, I managed to get some privately but my symptoms have come back. A recent blood test showed my oestrogen level was half what it was earlier in the year. Maybe the change in the manufacturer has something to do with it. I’m not sure what to do as the gel and other patches don’t work for me.

[bombsh3ll]

I have only ever used patches for IVF but just wanted to say don't be scared of oral estradiol - the difference in thrombotic risk is absolutely marginal and not clinically significant for the majority of healthy users.

So many women struggle valiantly with patches and gels, paying through the nose for "off licence" doses which aren't getting in and they are left with miserable symptoms and at risk of long term health consequences such as osteoporosis.

The mouth is designed to get things into the body whereas the skin is designed to keep things out. This is why transdermal medications are a nice theoretical concept but are often poorly effective.

A small number of women for example with a clotting history and who aren't on blood thinners, have a medical case for transdermal but the overblown fear around oral driven more by social media than clinical evidence, is responsible for an awful lot of suffering in my opinion.

[sheila99]

So the possibilities are
  Your own production has fallen, and this can happen even several years after meno
  The patch is different as it's a different manufacturer. If you do a search I think there's also been someone who seems to have had a duff batch. And if you didn't buy it directly it's possible it's been stored incorrectly.
  It needs longer. Although flushes usually go within a couple of weeks most other symptoms take far longer, and particularly skin.
  Estradot is more available now so personally I'd get a new batch and see if it makes a difference. If it doesn't I'd wait the 3 months then do a blood test to check your levels.

[Anglichanka]

I am also having problems with Estradot having been settled on the 100 patch for years. Since the shortages, I managed to get some privately but my symptoms have come back. A recent blood test showed my oestrogen level was half what it was earlier in the year. Maybe the change in the manufacturer has something to do with it. I’m not sure what to do as the gel and other patches don’t work for me.

God that's alarming I hadn't even considered that. I can't really tell whether I was absorbing less before as I've had 18 months of severe heartbreak to deal with which was hard enough. I'll ask GP for a test and if refused I'll get a private one, and test on a new patch day and see where I am. Sorry you're also having problems.

[Anglichanka]

So the possibilities are
  Your own production has fallen, and this can happen even several years after meno
  The patch is different as it's a different manufacturer. If you do a search I think there's also been someone who seems to have had a duff batch. And if you didn't buy it directly it's possible it's been stored incorrectly.
  It needs longer. Although flushes usually go within a couple of weeks most other symptoms take far longer, and particularly skin.
  Estradot is more available now so personally I'd get a new batch and see if it makes a difference. If it doesn't I'd wait the 3 months then do a blood test to check your levels.

I think it's unlikely my own production fell just as I was switched to Evorel but honestly who the heck knows. I don't have hot flushes, my go-to symptoms are neurological and peeling skin. Thanks for your advice. Pretty sure the patches were correctly stored, they were kept in a bathroom cabinet. But again, who the heck knows.