Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Smokey on February 28, 2016, 12:24:02 PM
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Hi just wondered if anyone has changed from patches to gel and are they the same in relation to doses Ie is 50mg patch same as 1pump of gel etc. And do they work the same ?
Thanks Ann x
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They work the same way. I switched the other way. Specialist said that 2 pumps of gel was equivalent to 37.5 patch. So reckon you'd need 3 pumps to be same as 50 patch.
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I don't know but I will watch this with interest, as it's something that I have been wondering about.
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I will be following this thread with interest. I have only used patches, and a brief spell on oral Femoston.
I have been wearing a 50mg patch for the last 2 weeks since stopping Femoston, and I feel like it's doing nothing for me whatsoever. When I wore patches last year I felt like the 25mg patch did nothing either, but thought there was an improvement on 50mg.
But right now, they seem to be doing nothing for me. I have even checked the labelling to make sure the 50mg patches are still in date (they are). Not sure if they aren't working for me anymore because my own oestrogen levels are now lower?
When I see Dr Annie this week I am hoping to try oestrogel as I have heard very good reports about it re: better absorption.
I thought that 2 pumps = 50mg?
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50mcg is a low dose for your age grl I would have thought? I thought that was a dose for (ahem) those of us further along the road ;D
I switched from gel to patch as I was a bit lackadaisical about it really, and so I was experiencing palpitations and the like.
My doc put me on 100mcg estradot because she said the younger you are the higher the dose. I felt more stable immediately but after a while a bit wired so I chopped a bit off and now have been fine for months. I guess it's about 80-85mcg because the 75mcg patch was too little and saw a return of flushes.
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Hi Nina
Yes, much of what I've read indicates that if you're in your 40s, and going through peri, then you need much higher doses of oestrogen than a woman in her 50s. I think this is especially true if your main symptoms are the cyclical anxiety/mood swings etc? I know of Prof Studd's site he advocates 100Mg patches to alleviate such symptoms in women with extreme PMS, or who are peri.
I could add a 25mg patch to my current 50mg one, but frankly I'm so scared to do anything more to my poor body before I see Annie Evans this week. But, it's so very, very hard as I feel very low, wretched and extremely anxious. I am hiding this as best as I can from my children (they're just about old enough to start noticing things) but have cried with DH several times this last week. Which is totally unlike me!
I am assuming she will tell me that what I need is just more oestrogen?
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Yes I guess she might!
Good luck with it, I hope you get some relief soon. I too used to be very anxious, sometimes a shell of my former self but I feel a million times better now.
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I really didn't rate patches at all, I found them to be very ineffectual.
Firstly, despite going up to the 100mcg dose, I never managed to get enough oestrogen out of them - this was confirmed by blood tests. They never really stuck very well and but still managed to leave a horrid black mark which was difficult to get rid of. I also found they irritated my skin and left an itchy rash. Lastly, I really hated going around with a patch stuck to my backside.
I think the gel is a million times better and I would never want to go back to patches.
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Thanks Nina
I very much hope I get some relief very soon, too.
Was anxiety your worst symptom? How did it effect you?
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Well now that is VERY interesting. Maybe 50mg in a patch just isn't enough for me, which is why I feel so awful on and off. I have to see my GP next month for a review and will see about some gel and in a higher dose.
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How exactly do you feel Trufflecat? Did a 50mg patch used to be enough for you?
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I started out with them 8 months ago GRL. I am in peri and 52. Still having fairly reg periods. I have what prof Studd would call reproductive depression (I think) with awful pmt every month. The patches have helped according to dh! They have evened things out a bit, but it's far from perfect. My GP mistakenly put me on Utrogestan for 25 days but has now switched me to 200 for 12 days. I have had two weeks with no Utrogestan, just the oestrogen and am now on day 2 of a really nasty headache. (I have premenstrual headaches too) last weekend I had a very low bout of pmt like feelings.
I will be very interested to hear what Annie Evans has to say to you. Good luck and I hope you feel better soon x
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A 50mcg patch is a low dose of HRT and when I was on that dose with a Mirena coil, it did nothing to relieve my temperature control problem - I have never had hot flushes, just a dodgy thermostat. I also used to get headaches and low mood and looking back at my blood tests results for that period, they registered at about 80.00 pg/mL (293 pmol/L) which might be OK for some people but is way too low for me and I never felt good on it. My oestrogen must have been very low because I never had periods while I was on this regime whereas I always had periods with the Mirena coil before menopause.
Trufflecoat, I know you are not a patient of his but Professor Studd would never prescribe 200mg of Utrogestan for 12 days for a woman with hormonal depression, progesterone intolerance or severe PMS. His normal prescription for people in that category (myself included) is 7 days of 100mg Utrogestan each month. Do you take it vaginally?
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Hi Mary. I am sorry if I am hijacking this thread.
My GP didn't realise that the Utrogestan taken for 25 days at 100mg is only for post menopausal women, fortunately someone here mentioned it and I told her and she changed my prescription a couple of weeks ago. My oestrogen prior to HRT was 321. Maybe I need a bigger dose.
I had seen that prof Studd likes to give 100,mg Utrogestan for 7 days only and am a bit concerned about what the 200mg might do. I cannot really take it vaginally as we have a fairly active sex life (my libido seems fine!). I managed to get Utrogestan after the northisterone made me horribly depressed.
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Trufflecoat your oestrogen certainly was low before you started HRT. Why don't you try the gel? It is more flexible and easier to adjust the dose to suit your needs. I have found it works much better for symptom control too.
Re the Utrogestan, I take your point but you can mix and match and take it orally and sometimes vaginally if you like.
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Thanks. I will make an appointment and ask about the gel. The doc seemed to think that my oestrogen was normal at that level.
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Trufflecoat, this is where it get complicated, your blood levels may seem to be normal on paper but that doesn't necessarily translate into decent symptom control. Some women need to have oestrogen blood levels significantly higher than the supposed normal levels in order to get symptom control. As always, it is not an exact science. I have had this conversation with my gynaecologist many times and she agrees. When my level was the same as yours, I didn't feel good at all. Unfortunately, what works for some women doesn't work for others. The only way of knowing what really works for you is to get to a level where you feel good.
By the way, I forgot to mention this before on this thread but my understanding is that 2 pumps of gel is the equivalent of a 50mcg patch but again, when it comes to blood levels, the results for me are wildly different and I get much more into my system from 2 pumps of gel than I did from the 50mcg patch. Much of it is about how well you absorb each product.
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Smokey - no-one can say what the equivalent dose of patch to gel is! The dosage of oestrogen for the different delivery methods - tablet, patch, gel is derived from studies of groups/populations of women and the average taken. This is not an exact science!
Therefore what is given on this site under HRT preparations - is low medium and high dose and that's all you can really go on (although there is some inconsistency with this with tablet HRT!). Women vary so much in how much they absorb into their system from each method and the resultant oestrogen levels. Not only that we differ in the level ofestradiol at which we experience symptoms.
50 mcg patch is classed as medium dose. The starting dose for gel is 2 pumps which is also medium I think as it;s the standard post-menop dose.
However some women will get much higher oestrogen levels from 1 pump of gel than a 50 mcg patch! With gel it depends quite a lot on the size of area you spread it on because the estradiol is absorbed before it dries - so too large an area will possibly dry too quickly and less is absorbed? Absorption for both transdermal methods will also vary according to where on the body the product is applied (thickness of skin), and the products you might have used on your skin as well.
Whether you choose patch or gel is a matter of preference - firstly on absorption (for you), and secondly whether you prefer a twice weekly change (most patches) or a daily or twice daily application (gel). Whichever method you use - if your oestrogen dose is too low then you need to try to increase it. This might be easier in small steps with gel since patches only go up in 25 mcg increments - but most women who use them and are happy with them find this OK.
If you are post-menopausal in your 40's then 50 mcg may not be enough but if you are peri-menopausal so much depends on what your own cycle is doing ie whether your own oestrogen levels are not even reaching the peaks at ovulation that they were, if they are dipping really low, or surging really high. What might be the right dose to deal with the lows might be too much when added to the highs? It is so hard to repliclate what our own bodies would be doing - but the best we can achieve is to try to find a regime that makes us feel well for most of the time - and better than we do when not taking it.
Hurdity x
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Thank you. Honestly witnout the info gained on here I would know nothing.
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Nail polish remover gets rid of the marks from patches. My tip of the day 😀
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Thanks everyone for taking the trouble to reply.
I am seeing my doctor this evening to discuss my Hrt change. I am currently on 75mg patch including (50 prog part.) I am also eight weeks off antidepressants and am all over the place at the moment anxiety low mood nausea aches and pains scary feelings rushing through me no hot flushes bit warm in bed then goosy etc. Digestive problems lost interest in everything, worrying about everything etc. I feel like I'm going mad!
Gypsyroseleigh what times your docs app today, hope it goes ok.
Ann x
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Somewhere on this thread someone has mentioned equivalent doses. The absorption of either patch or gel can vary from women to women. 2 pumps per day is the average dose that is recommended but some women find this too little while for me it's almost too much. On 2 pumps of gel per day my oestrogen levels are around 600!!!! so this is a medium dose. I clearly absorb and store oestrogen really well. Other women get far lower readings on 3-4 pumps. When I tried patches, I got a big boost in the first 24 hours and it tailed off really quickly, so by day 3 my flushes were back.
It's trial and error but at least with the gel you can adjust the dose - even though the application can be a nuisance to get used to. DG x