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[monicap]

I'm 46, in late perimenopause and currently on oestrogen (estradiol) and utrogestan (micronised progesterone). My oestrogen has been raised from 50, to 75 to 100 to see if this helps with arousal/orgasm difficulties. After a month on 100 mcg my GP is going to try me on testosterone gel - afraid I'll be allergic to it too

All forms of transdermal oestrogen irritate my skin/provoke an allergic response. I'm desperate to find a a form of transdermal oestrogen that doesn't. Does anyone have any ideas?

The story so far:
OestroGEL - tried it once on thighs and got a bad case of contact dermatitis. Red, swollen, hot and itchy. It took weeks to clear up
Estraderm patch - itchy, raised red and ezcema like skin where patch had been, some swelling around patch. Skin hard and slightly swollen when I took it off, post-inflammatory pigmentation lasted for weeks where patch had been
Estradot patch - same as Estraderm (above) but at least it's a smaller patch
Lenzetto spray - used once on arm, went bright red, hot and itchy so never used again
Evorel patch - same as Estraderm and Estradot

I've been using VAGIFEM (estradiol pessary) with no problems for the past two years. Adding systemic HRT has helped so much with vaginal atrophy, urge incontinence, pain/numbness/tingling in arms. I really want to stay on it but this is getting me down. I can't imagine living with the skin irritation long term. I'm probably applying too much hydrocortisone as it is to deal with the symptoms. My GP is baffled. According to her most women only need to change patch once to find a brand that suits.

[CLKD]

Keep using the 'vagifem', it's probably the patch surround which causes the reactions, i.e. the sticky bit against the skin.  If the 'vagifem' isn't enough, U can use it nightly to keep symptoms under control.

Do U react to anything else, i.e. plasters?

[monicap]

No, I don't normally react to things. Definitely not plasters.

As you say (and given that I don't react to Vagifem) it can't be the oestrogen I'm reacting too surely - must be the patch adhesive or some other ingredient(s) in the spray/gel.

I'm sticking with the patches (Estradot) for now (despite the discomfort) in addition to Vagifem until I speak to the specialist in a month as I don't want to get the hot flushes/urge incontinence/vaginal atrophy/arm pain back.

[CLKD]

I would speak to the specialist ASAP - the 'vagifem' is unlikely to cause such extreme reactions, but the sticking patches may do. 

We have threads on 'bladder issues' and 'vaginal atrophy' on the Forum - do read. Make notes ;-)

[sheila99]

You could try oral oestrogel or there is an oestrogen implant but that will require a specialist. Oestrogen made no difference at all to my libido though it does for some women. If you are prescribed testosterone you could try the sole of you foot. I use it there (the softer skin under the arch) because my thigh got hairy. I tried front of elbow but that went red so it's possible using a tougher patch of skin would help.

[monicap]

Thanks for the testosterone tip Sheila! That could be very helpful down the road. Wonder if anyone applies their oestrogen patch on their foot arch? Is it even an option? Might help with the skin irritation...

Unless the specialist has some bright idea I have been thinking they might offer oral oestrogen or the pellets, as you suggest. Apart from all the obvious reasons for preferring transdermal oestrogen apparently oral oestrogen isn't great for libido/arousal/orgasm. Given that's a big issue for me I suppose I would prefer the pellets.

One thing that worries me about the pellets. Do you end up with lots of scars when they change them every six months or do they use the same site and re-open the scar?

Btw Sheila, you say oestrogen didn't help at all with libido. If you're comfortable answering could you let me know if testosterone did help. I'd love to know what I can expect. My problem is not so much with libido. It's more that I'm much less sensitive. Arousal takes a lot longer. My vulva/clitoris doesn't become engorged any more so it feels like a blood supply issue. Orgasms are difficult to achieve and pretty meh. To the point where I'm not sure if I've had one sometimes. I always found it easy to orgasm until recently. And they were pretty satisfying ones. The change was quite dramatic and coincided with a five month spell without my period.

[sheila99]

Have a look at the 'testosterone here we go' thread, lots of experiences on it. Don't expect to be like you were in your 20s but it has helped me. They will only prescribe it for low libido, mine was zero having been cyclical for a few years in the run up to total death and rather like your experience not worth the effort. T has improved my muscle tone and I think that's the thing that caused the poor response. I had problem pulling muscles too (actually the biggest reason for wanting it) which has now gone and I no longer have to do regular pelvic floor exercises.

[monicap]

Will check out the thread. Thank you. What you say about muscle tone is interesting.

[monicap]

Well, I tried the oestrogen patch on my foot arch (for the hell of it!) and the irritation was a LOT less. Started to get itchy after about 24 hours though.

What does this all mean? Why am I so bloody sensitive to ALL the patches I've tried...the gel AND the spray? Is there ANY point in me trying the few transdermal products I haven't so far? These are:

Patches - FemSeven Mono, Elleste Solo MX, Progynova
GEL - Sandrena

Any ideas (even long shots) very welcome!

[Joaniepat]

Is there any chance you could go for allergy testing to discover exactly what you are reacting to?
JP x

[monicap]

Hi Joanie when I asked the GP she said they can only test for common allergens and these gels/patches have so many different ingredients and that these wouldn't be classed as common allergens.

Does this sound right?

[CLKD]

If the Surgery isn't able to test, your GP could have referred U to a dermatologist clinic where they will be set up 2 test lots of products that might be causing reactions.  Might be worth while asking for a referral?

In the 1970s I had lots of skin pin prick tests due to constant sneezing.  3 times nowt showed up.  In the late 1990s I realised that I am affected mainly by cat dander as after my cats died, the sneezing improved  .

It is probably the sticky bit that might b the culprit?

[monicap]

Yes CLKD, it's probably the sticky stuff in the patches but obviously something else in the spray and gel. So possibly multiple things. I think I will ask about being referred to a dermatologist when I talk to the specialist next month. See what they say. My GP hasn't suggested it once.

[Joaniepat]

Agree with CLKD, I'm sure a dermatology clinic would test for things other than common allergens. They would at least have an inroad with the patches and other treatments you have reacted to, so not necessarily like looking for a needle in a haystack. I've never had it done though, so am speaking from a position of ignorance. Any chance of seeing a dermatologist privately?
JP

[CLKD]

Your GP can refer you to a Dermatologist.