Non-absorption of transdermal patches

[Admin]

I’m not sure how many ladies here use oestrogen patches, but I have a suspicion that I’m not absorbing mine properly. I’ve had a couple of incidents over the last few months where, for no reason, my insomnia and hot flushes have returned, and currently that’s what is happening. For the last few nights I've had an awful lot of trouble getting to sleep and last night in particular I was woken twice with really bad sweats (and it's the middle of winter here!!).

I’ve even put two patches on over the last couple of days (100mcg) and still had no improvement. So I have taken the patches off altogether and I’m now trying some transdermal gel, but I’m not sure how well I will absorb that if I'm not absorbing the patches.

I’ve just been doing some reading about patches and it does seem that, while they are very convenient, for some some women they are the least reliable when it comes to absorption. So it looks like I might have to go back to tablets. I would have preferred to not take any HRT orally, but if the absorption rate is going to be a bit dodgy, I will have to, because when my oestrogen levels drop I have insomnia, depression, anxiety and night sweats, so I’m not a happy bunny at the moment.

I have an appointment with my doctor in a week’s time, so I’m hoping the gel will work well enough to settle my symptoms until then, otherwise it looks like I’m back on to my trusty sleeping tablets…..sigh…. Just when I thought I had all my prog intolerance problems sorted out – now this. When will I get all my meno problems sorted out?

[Admin]

I hope you're right. I'm not sure how much the gel costs if I get it on prescription from the doctor, but it's very expensive to buy from Goldpharma compared to the patches/tablets, and I'm only a part-time worker these days so I have to be careful how much I spend on things

I really have no idea how much to use of the gel. Last night I gave myself 3 squirts, and I decided to give myself another 2 squirts this morning for good luck. Then tonight I've just given myself another 3 squirts, plus I've just taken my Utrogestan orally, hoping that it might give me more of a sedative effect that way. I've also got some melatonin to take as I'm wanting to avoid using the sleeping meds if I can help it.

Fingers crossed that I won't be tossing and turning for another 2-3 hours tonight.

[Admin]

I'm not totally sure but I think the only gel we have here is Sandrena, but I will have to check with my GP as there could be others. Maybe I can get a prescription for both the tablets and the gel from her and if the gel doesn't work I will have the tablets to fall back on without having to make another appointment with her.

Thanks - I'd appreciate it if you could to a dosage comparison between the two, because I'm totally useless with that kind of thing....lol...

[Admin]

Yes, I was using Estradot, but I’ve taken it off and I’m just using the Estreva now. I did sleep a lot better last night, thanks, so hopefully the gel is starting to kick in.

I’m actually fairly certain it’s the patches that are causing the problem, because this is the second time this has happened. So either it’s me being a bit hit and miss about absorbing them, or you get a few dodgy patches every so often.

I called into my trusty chemist this afternoon to have a chat with him. He’s been through my HRT ups and downs too…lol.. Anyway, he said the gel we have here is Sandrena and it’s only AU$13.50 for 28 sachets. In theory you’re supposed to use one sachet (1mg) per day, but of course that is going to vary from person to person and I might need more. I asked him what his experience was with patches versus gel and he said that the patches can be a bit unreliable with absorption, and that he actually sold a lot more gel than patches, so that could be a clue.

Anyway, I’m quite happy about the price. For some reason I thought it was going to be a lot more expensive, so I will ask my GP for a prescription when I see her next week. Generally with HRT you get the initial prescription with 5 repeats, which should last a total of 6 months, but of course if I need to use more than one sachet a day I will go through it more quickly, but at least they don’t cost the earth.

I can ask her about doing another blood test, but I don’t think she really bothers about tests too much. She prefers to go on the symptoms, and all the symptoms I had pointed to me not getting enough oestrogen. By the time I see her next week my levels will hopefully be higher anyway, so a test probably won’t tell us very much.

[Admin]

Yes I think I'm fairly certain the patch is the culprit, and then after hearing what the chemist said I've decided to dump them altogther. Of course I still have to find out if the gel will work for me, but so far my symptoms seem to be settling, so fingers crossed.

I have taken HRT orally before, so if I have to go back to tablets I'm okay about that, but I want to give the gel a try first to see how I go.

There was quite a discussion on MM a while back about a number of Estradot women who were starting to experience meno symptoms again. There was a suspicion that there was a problem batch, but I think the manufacturers disputed that. The first time I experienced problems with Estradot a couple of months ago I asked my Chemist if he had heard any complaints and he said no, so maybe it's just an individual thing, and the patches are a bit unreliable for some women.

Anyway, after being through the meno-mill over the last 7 months or so the one thing I want now is stability. So I'm not going to continue using something that could be a bit unreliable. Bring on the gel.

[Jenny Wren]

I've been using estradot 50 for several months now and haven't had any problems with the patches, re flush control etc.

When I saw Prof Studd he prescribed 2 pumps of Oestrogel going up to 3 if needed. I only needed 2 for control of symptoms. But I think I was getting more O from the gel because my breasts started to plump up when I was using it.

In the end I had to abandon the gel as I was always forgetting to apply it and having to rush back home and put it on, or waking up in the middle of the night realizing I'd forgotten to apply it.
My brain is just too scatty at the moment to remember and changing a patch on Wed and Sat I can just about cope with.

[Admin]

Well, I'm not so sure now that the gel is working either. Last night was horrible again, after the previous night being quite good, although I didn't have any flushes last night, so maybe things are improving.

Maybe it's still too early to know if the gel is working and I need to give it a few more days. I'll have to keep with it until Friday anyway because that's when I've got my GP appointment. Maybe I should just go back onto the tablets and be done with it.....?? Sigh - why can't meno be easy.....

[Admin]

Last night was another horrible night, so I'm having my doubts that the gel is helping either. Depression and anxiety levels are through the roof again. I had to resort to using some diazepam last night, which I hate doing, but I have to sleep.

I don't think I'm going to wait until Friday to see my GP. If tonight is no better, I'll see if I can get an appointment with her tomorrow and just go back onto the tablets. Can't stand this phaffing around and being so depressed about everything....

[jacksfullofaces]

I use about 4 1/2 pumps of oestrogel daily and my estradiol levels haven't measured too high. One thing about oestrogel it is easy to learn to take a quarter of a measure at a time. I use 2 measures morning and two last thing at night. The other two doses are a quarter each if they are required. I'm using thyroid medication which means I need a higher dose.
Also my doctor told me that required dosage can vary from day to day due to factors including stress, exercise or illness eating up the circulating estradiol. Also estradiol does react with other medications. If you use opiate based analgesics including codeine or anti depressants it will lower your estradiol levels.
Jacks

[Admin]

I did go back to see my doctor on Monday and considering the symptoms I was experiencing her opinion was also that I wasn't absorbing the patches and therefore may have a problem with the gel as well. That's not for certain mind you, but frankly I've been through so much trying to get my HRT sorted over the last 12 months or so that I just don't have the energy to try something else that may or may not work.

I'm now back on tablets, and I know that in the past they have worked for me, so I will see how I go with that. I asked her about doing a blood test, but she's not really that concerned about doing tests. She'd rather gauge things by the symptoms and I feel the same way.

To be honest I think I have always had a problem with the patches but it's been getting masked by me also having to use ADs and Diazepam for my insomnia. For quite some time I was using 1 1/2 patches to give me 75mcg and even when I started increasing that to 100mcg I still felt no difference.

It's always been in the back of my mind that I may just be one of those women who has trouble absorbing anything through the skin. The very first hormone treatment I tried, about 2 years ago, were the compounded bio-identical creams. They worked really well for 2 months, but then stopped working. When I spoke to the compounding pharmacist he said that some women can have trouble absorbing the cream. So I'm assuming that this has been my trouble all along and that I will probably have to stay on tablets.

Anyway, I'm still going back to see my GP on Friday because I'm having a BMD test done tomorrow and I need to see her with the results. Hopefully there will be a small improvement in things by then.

[Countrycottage]

heya ladies..i had huge issues with estradots and so did quite a few other ladies...we all reported them as we were doing well untill we got batch numbers in the 50,000's.

re implants...i wont be having another one...i had 4 weeks of feeling brill then the rest was awful. i didnt absorb them as i should...took bout 7 weeks to kick in then i absorbed the whole lot overnight and ended u with high levels of 3000 (uk numbers)....weirdly i felt great on those high numbers apart from insomnia and exhaustion but then in ten days i dropped from 3000 down to 700 and the effects fro that were awful....

so im now having weekly bloods and introducing more sandrena in until i can get a stable level...ive figured out though i need at least 750 to function normally..

re sandrena.....its a smaller amount of carrier gel (but same amout of e) one 1mg sachet is equiv to two pumps of oestrogel. i was using 6 pumps of oestrogel a day prior to implant so im hoping in a few weeks all my e from implant will be gone and thats what i will be using.

sandrena is great for me...its a tiny amount of gel and far less messy.

implants work differently for everyone..not for me but other ladies swear by them...im a former pmdd sufferer and dont react well to any fluctuations at all.

x

[Admin]

I haven't ruled out giving Sandrena a try at some stage, but I've been through so much meno upheaval with prog intolerance and non absorption of patches, that I just want to get settled on my oestradiol tablets and remain settled for at least a year before I start fiddling with things again.

I definitely won't be using patches again. I know they work really well for some ladies, and I do like the idea of not taking it orally, but I think for some of us they are just too unreliable. I also have no interest in using implants (if they were even available here) because they just seem way too "permanent" for me. If it's not working, or not the right dose, you're stuck. That happened to one of the MM ladies I used to talk to a lot.

I'm still sticking with the oestradiol tablets. I've been on them now for 2 and a bit weeks. It's hard to tell how things are going because I had to increase the diazepam so I would sleep, so I'm sleeping really well, but the proof of the pudding will be when get the dose down to a much lower amount.

I'm currently taking 2.75mg Diazepam (which is still quite a low dose) and reducing the dose by 0.25mg every second day. So it will take another couple of weeks at least. By that time I will have been on the oestradiol tablets for at least a month, so hopefully everything will be starting to mesh by then.

[Poppy]

we all reported them as we were doing well untill we got batch numbers in the 50,000's

Just checked my next 6 months' worth hazeyj & they're all in 50 000s

I've been using estrodot 75 for about 9 months now, last couple of months have been quite erratic mood/flush-wise.

Not had my hormone levels checked for over 3 years.

[Countrycottage]

i use gel instead now poppy x

[Robyn]

One day I would like to go back to trying the patches, but for the time being I think I need to find something that works long term and then maybe down the track I will have the energy to try experimenting again.

[Countrycottage]

it was the 100's mainly and the mhra are still investigating...awful experience thought i was going mad x