Menopause Matters Forum
Menopause Discussion => Personal Experiences => Topic started by: Briony on September 20, 2015, 09:56:05 AM
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Just wondered if you take a 100mcg patch and do not ovulate (because of the patch rather than the fact you no longer ovulate anyway)? Prof Studd and the PMS Society both suggest taking 100-200mcg patches in order to actually suppress your own hormones and therefore prevent the ups and downs many of experience in peri. They seem to think 200mcg is best, but that seems very high to me. I'd be interested to know if anyone has taken less and still had ovulation suppression?
Thanks :)
Taken from website:
Summary:
- Oestrogen therapy is effective for the treatment of postnatal depression, premenstrual depression and perimenopausal depression the triad of hormone responsive mood disorders.
- Transdermal oestradiol 100 mcg or 200 mcg patches producing plasma levels
approximately of 500 pmol/l and 800 pmol/l respectively should be used.
- These patients often require plasma levels of more than 600 pmol/l for efficacy.
- Consider adding testosterone for depression libido and energy.
- They require a cyclical progestogen or Mirena IUS if the patient still has a uterus.
- The most effective longterm medical therapy is oestradiol patches or an implant of oestradiol and testosterone with a Mirena IUS in situ.
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An effective hormone therapy for severe PMS is the use of transdermal oestrogens for suppression of ovulation (24). This can be by gel (2.5-5.0g grams daily), patch (200 mcgs twice weekly) or --in those patients who have already responded well to transdermal oestrogens -- an oestradiol implant of 50 mgs every six-months, which gives long term therapy (25). They should be warned that they may feel less well in the first two weeks -- rather like the mood changes seen in early pregnancy -- and that it may not work for the first month until ovulation has been suppressed. Oral oestrogens may also be effective, but there are no published studies to support this.
Oestradiol patches are an alternative and our original double-blind cross-over study used 200 mcgs of oestradiol patch twice weekly (21). This produced plasma oestradiol levels of 800 pmol/l and suppressed luteal phase progesterone and ovulation. Once again this treatment was better than placebo in every symptom cluster of PMS. Figure 4 shows the response to oestradiol treatment and placebo in a six month cross-over study. This is now our treatment of choice in severe PMS.
Subsequently a randomised but uncontrolled observational study from our PMS clinic indicated that PMS sufferers could have the same beneficial response to 100 mcg patches as they do with the 200 mg dose. They also have fewer symptoms of breast discomfort, bloating and there is less anxiety from the patient or general practitioner about high dose oestrogen therapy.(22) 21 day progesterone assays in the patients receiving 100 mcgs showed low anovulatory levels prompting the intriguing question that even this moderate dose might reliably suppress ovulation and be contraceptive. Clearly, a great deal of work must be done before we can suggest that this treatment is effective birth control but it is of great importance because many young women on this therapy for PMS will be pleased if it also was an effective contraceptive. This is a study which needs to be conducted.
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Sorry no one has been along to comment ……. don't take HRT myself ::)
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Thank you for replying though ... now I feel less lonely ;) :thankyou: