Transdermal Hormone Replacement Therapy: Patch Vs. Gel - What's better?
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- เผยแพร่เมื่อ 22 พ.ค. 2024
- Transdermal Hormone Replacement Therapy: Patch Vs. Gel - What's better? // Thinking about starting on transdermal hormone replacement therapy and not sure what is best for you? In this video, I break down the pros and cons of both the transdermal estradiol patch and the transdermal estradiol gel and help you decide what is the best transdermal hormone replacement therapy for you.
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• Transdermal Hormone Re...
What HRT method do you use and do you think it's working perfectly?
Hello from Berlin! I use spray.
And progesterone pill. The spray is estradiol.
I use the patch. I wouldn’t say “perfectly,” but it takes away most symptoms. I don’t do well with progesterone for some reason, but I do have a benign pituitary tumor (also I don’t have a uterus).
Mirena IUD & Oestrogel , I’m in UK. Was on patch for a few years which helped most symptoms. Changed in December , using less gel now and this method is suiting me well now , no more bleeding ☺️
I take 1.5mg of estradiol orally. What are pros and cons of oral estrogen??
I love the patch. I've been using it for 10 years now through perimenopause and now in menopause and can't imagine life without it.
Love this. My first day of the patch I am excited. ❤
Love this. My first day of the patch I am excited. ❤
Suda etkisi geciyor mu? Water resistan?
Please do a video on the pros/cons of oral estradiol
Yes, oral estrogen video. Who should have oral estrogen? What if you have a cervix but no uterus, what are the best options?
Can you do a video on thyroid medication and interactions with Estrogen. If I up my thyroid drugs it drops my estrogen and I feel terrible.
Yes to an oral med video!
Online menopause doctors need to speak more about a thickening uterine lining caused by starting HRT and what to expect with this over the first year.
Yes!! My Midi Health provider discussed this with me. To be sure to get annual transvaginal Ultrasounds to check fibroids & uterine lining and to get annual mammograms. I'm not a fan of mammograms for many reasons so I opt for breast ultrasound instead.
Agree! This is happening to me and I feel lost on if this is safe or not
I’m assuming this is what’s happening to me. Been on the Combipatch since March and I’m bleeding so much. I switched to the highest dose of the patch and it stopped for about a week then started again. I’m so lost. I don’t know what to do.
Thank you so very much , really helpful 🙌
Hi Dr. Hirsch, Thank you for all the wonderful information you provide. I follow you on every platform. Please tell us more about oral estrogen.
Hi Heather! Please do a video on oral estrogen and the benefits/risks. Thank you!
Good info thank you
On .05 weekly estradiol patch. Was 3 months on .025 and just switched. I'm 57 with the Mirena IUD and although I don't have a ton of symtpoms, wanted to try it for bone, brain and heart health. No side effects for me thus far. I'm on zero other medications.
I'm similar to you. 48 with Mirena.
Starting the patch next week. What made you up your dose?
@Not0a0City0Girl0 After listening to Meonpause Taylor videos, .05 is the minimum dose you need to protect bones, heart and brain. After a few months on the lower dose, I felt no effects and I feel better now. Good luck to you.
I would love to hear about your thoughts on the pill form of estrogen. Thanks
I set a reminder in my phone to change my patch every 4 days. Very easy to remember using that method. There’s a shortage right now where I live so I’m switching to the gel until stock is replenished. Patch is much easier to apply.
Good information . I use patch and pill (Progesterone) . Had the iud, bled for months. Disappointed that it didn’t work for me
I’m fine with the patch even though it does leave little circles on my belly. It’s so convenient and easy to change twice a week.
Please add Minnesota!
Please make video on hrt for oral or pill. Thank you
My OBGYN says I need a higher dose of HRT because I am in early perimenopause. Is it true that women need higher dosages when they are earlier in their menopause transition?
Yes younger people need more. I'm on 2 pumps of estrodial it's not working need to go up again I'm 40
Yes! Can you please do a video on oral estrogen? Currently on the .01 patch but I may need a little more. Is that when oral is needed? Does it come in higher doses? Also…can a woman add a second lower dose patch to the original patch?
I use estrogen and testosterone pellets, plus 200 mg. of micronized progesterone at night. This protocol works perfectly for me, as transdermal creams and gels are not absorbed well, in my case, and patches gave me intense headaches. Oral estradiol carries too many risks for my comfort level and E and T injections had me on a roller coaster ride. My pellets have given me my life back (hysterectomy/BSO in 2006)!
Doctor what is your opinion on Climara?Does it work? Is it safe?
Dr. Hirsch, could you possibly address how an autoimmune condition may impact what you decide to prescribe for patients in perimenopause or menopause? I am on a low-dose combination birth control that is flaring autoimmune symptoms. I read some studies that indicated that certain forms of progestin may be inflammatory (raise CRP levels, for example) in some patients. I am wondering whether natural progesterone (as noted in the studies) may be a better choice for me.
Thank you so much! I love your channel!
I'd really like to hear all about Bijuve, and if it's suitable for migraine sufferers, unlike the other oral HRT options. Does it have any health advantages over transdermal. Or disadvantages? Thank you 😊xx
Yes to oral HRT video. I’m a poi and now 39 and in menopause and really wanted to see what my options are.
Also can you do a video for early menopause especially the people with not many symptoms…I’m more concerned how this will affect my health (I have symptoms but I can live with it …I’m more concerned long term issues for early menopause ppl like me if you are not on HRT) I feel I never saw any video anyone talked about our group of ppl
Gel all the way ladies👍
I apply it to my thigh every night right before my retinol facial serum! I never miss😆 It recently came out in generic and I get it for $31 from a GoodRx coupon.
I don’t recommend the spray because the nozzle malfunctions and the pharmacy can’t help you. You have to get in touch with the drug manufacturer directly. I also use a IUD so easy peasy HRT for me in my opinion😊
The gel is generic now? I can’t find that where I live.
@@Alliecat670 Yes it went to generic August 2023. It was a challenge getting it at first. They had to order it in for me and they automatically special order it for me every month. I didn’t give up in the beginning even though I had to be off my HRT for several days.
Tried gel did not absorb for me.
You apply the estradiol gel at night? I was instructed to apply it in the morning.
Waiting for providers in NC.
Currently on Combipatch. So convenient and ai do not feel as warm all the time, but I struggle with some bloating and heaviness in mid section since starting it. I am considering going another route. I want to be sure I take enough to prevent heart disease, Alzheimer’s and Osteoporosis.
I’m on the Combipatch since March and I can’t stop bleeding. I’m so sad that I’m gonna have to switch off the Combipatch
Can you share or do a video on the difference between HRT & Bioidentical Hormone Therapy ? Thanks
I was on the patch for 3 years but recently switched to the gel because of soon irritation. I’ve been applying in the morning, but I’ve had horrible night sweats since starting. I’m going to start applying at night to see if my symptoms lessen.
My meno specialist has me on a 0.05 2x weekly patch plus one half of a pump of Elestrin 0.006% gel morning and before bed. We tried the 0.75 patch it was too strong for me. After several years of the 0.05 biweekly patch started to wane. Symptoms were returning, not as intense as without estrogen at all but enough to really get my attention. My engineer fiancee made me a ring to place on the pump, measured it so that I only get 1/2 of a pump. I feel so much better doing it this way. The 0.006% Elestrin is not as strong as divigel. It comes in two strengths the one I use is the lower strength. I just know it works for me and I am sticking with it. :*)
So helpful thanks! I like the combo strategy
Are you in the US? I was on Elestrin gel for years and then one day, it was backordered and then I was told they weren't making it anymore. Is it back on the market now? I'm currently on the spray but I much preferred the Elestrin and it was cheaper than Evamist.
Can you do a video about smokers and hrt, i heard the transdermal route is the safest option for smokers.
I’ve been on the 0.05 patch for a few years, ever since my doctor took me off pills because of increased risk of stroke due to systemic lupus. Question: If the patch doesn’t distribute estrogen evenly throughout the whole week, does that mean it’s not doing as good a job as a twice weekly patch? Is there a significant enough difference in benefit to seriously consider switching? thank you for these very informative videos. You’ve done a great service to so many women.
I've used both the weekly and the twice weekly patches and find the twice weekly better in that they are much smaller in size, and it stays adhered well the entire time - unlike the weekly one which would start losing its stickiness and coming off before then end of the week. So it makes sense to think I'm getting better/more consistent absorption with the twice weekly patch since it remains completely adhered the entire time.
We need someone in Little Rock, AR. Can you talk about the Evamist equivalent? So I have done some research but it is not clear on how much 1 spray vs 3 sprays and what it is equivalent to in patch form. One article I came across is very confusing as it states 1 spray is one amount but adding the 2nd spray doesn’t double the amount like you would think. It also stated that in the trial there was almost no difference between sprays 2-3 for symptom resolve. I was given a RX for it but I have no real answers that are clear like the gels/patches/orals.
What do you think of hrt pellets?
Can you do a video on the different types of oral HRT. I was curious about lozenges.
I have abdominal fat. Does that affect absorption? As I lose weight will more be absorbed?
Does the oral estrodial in Troche form increase chance of blood clots?
What about estrogen injections? Can you please talk about that !
I want to use an infrared sauna for all the health benefits and I use the patch twice a week.
Will the extreme heat change the estradiol absorption?
My doc gave me both prescriptions and said most prefer the patch so it’s up to me. However now in Australia, there’s absolutely nothing! Apparently global shortage and nothing’s coming in til June 2024 😢
I can't use the patch, I'm allergic to the adhesive. Ive been using a compounded product. I just heard about the gel and i have an appointment with my gyn to discuss.
I have been on all types. I love the gel, but it’s sooo expensive! Insurance doesn’t cover it.
I've been on the twice a week Estradiol patch 0.025 for 9 months now & vaginally insert at bedtime 100 mg of Micronized Progesterone Capsule. It's helped alot but know I'll need a tweak as my period completely stops. I apply the patch on upper buttocks. I have belly fat so it's not optimal to place the patch there.
I’m on once a week .05 patch. My only complaint is that it doesn’t stay on the whole time. Lately, it hasn’t even been sticking from day 1 and I’m getting hot flashes again! I’m wondering if the company changed the formula to “save money” at our expense!
What’s the difference estrogen and progesterone??
Can I use the spray anywhere besides the inner arm? It’s frustrating to have to worry about giving someone a hug or picking up a pet and transferring the estradiol onto them. Otherwise the spray is great!
PLEASE share your thoughts on the 2023 Danish research / study that links HRT to Dementia/ Alzheimer's , PLEASE! Thank you
Isn't the gel supposed to reach steady state over a period of time and therefore the blood levels (think it's 12 days) should be the same over the course of 24 hours?
I had a hysterectomy and still my ovaries. should I take 1 week off the estrogen patch or keep it on since I don't have a uterus?
Pellets are amazing. Dottie patch is also great. Compounded progesterone is also great. Anything generic has not work well for me and the adhesives are terrible.
As a single woman, I’m not explaining a patch to anyone.😆 The gel is perfect and discreet.
Please discuss starting hrt at 74, no symptoms, but want cardio protection.
Starting hrt 10 years after menopause has a high risk of having heart attacks, stroke etc.. I'm not sure about the patch though..
Hi Heather...i am over 60..am I able to go on Hrt? Would very much appreciate some advice... Thank you
I gained 17lbs on compound bioidentical creams. Tried the Wiley protocol and didn’t get my E up. Was doing mainly for prevention but the weight gain is not worth it.
I eat vegan, gluten free and am a gym rat. Was muscle bf starting - 103 lb and 5 feet.
Now 117 and trying to lose it before I try the patch.
Is there less chance of weight gain with the patch?
What about progesterone along with the patch? I have been having problems with the compounding progesterone and estradiol combo… is the progesterone causing all the side effects? Acne, bleeding, anxious feeling.. would an iud with progesterone work better since it’s not going through my my entire system?
Im in perimenopause I don't have a period since June 2023. I started HRT last month, estradiol vaginal cream 0.01g twice a week, and progesterone pills 100mg every day. I have my period back. I don't know if that's normal or if I had to adjust the dosage. Please help
I just started using the twice a week patch and was wondering how important it is to change it exactly at 3.5 days? Most places say every 3 to 4 days and I know a lot of people say they are very consistent with the days, but don't worry so much about the times. It works best for me to always change it in the morning after showering, but that means that one time will be exactly 3 days and the other time will be 4 days. Will I start to notice fluctuations on the 4th day or will it still have the same amount of hormone as the 3 day portion. I want to keep my hormones stable, but also don't want to worry about it if it isn't a problem.
I’m wondering this as well. I usually change it Mondays and Thursdays
I just started HRT. I am on my 2nd week and my question is do I need to apply the patch at the same time when I have to change it?
On combi patch with estrogen and northindrone. Should I switch to oral progesterone and estrogen only patch?
I’m wondering this as well. I’m having issues with bleeding.
Week 3 ptch. Gotta do my thigh as I sweat & have to use tegaderm. Weekly. But seems to wear off day 5ish. Is that a thing? Ugh the VMS w widespread joint pain along with my cp spasticity that seems worse w VMS is epic. But getting there. 48.
My doctor won't prescribe me a patch or pill because I smoke. I've tried to explain to her the patch, even as a smoker does not increase the risks of blood clots. I've been suffering for 3 years with menopause symptoms getting worse. Do smokers (trying to quit) have any options? Smoking is my only risk factor.Thank you for your videos.
Affordability is the biggest factor for me because I’m paying for it all out of pocket.
Isn’t there a pump that dispenses gel as well?
It comes in little individual packs
I’m in the uk and it’s in a pump , it’s great , called Oestrogel.
What is the percentage with bleeding concerning the patch? Do all women using the patch have bleeding ?
I'm super curious about this too...
I had bleeding with CombiPatch so had to switch to Patch and progesterone pill . No more bleeding . Thank goodness ! 😊
I spotted constantly on combi patch, biopsies and ultrasound all ok , changed to Mirena and gel but used more gel as I was told maybe my dose needed looked at …..tried more and more but still bleeding so tried less gel down to one pump of gel and no more bleeding since , this is about 6 weeks now . For me less is the best option which surprised me . I’m very happy now 😊
@@nikkim4016 CombiPatch was interesting. Started with the lower dose progesterone Combi patch and did fine for about eight or nine months. Then switch to the higher dosage of progesterone Combi patch, and did fine on that for about eight or nine months. Finally ended up on the estradiol patch and progesterone pill. 🤷♀️
I think I have some sort of progesterone absorption problem. LOL
@@nikkim4016 thank you, this is so helpful!
Where I live, the gel has been back ordered for several months and the price is insane ! With insurance, it would still cost me $156 per month! Insane !
I went with the patch
I am on the 0.25 wkly estrogen patch and love it! How do you know when to increase to 0.5 ? I am doing well, but would I get a better benefit?
I've heard her say in other videos that the lowest dose that provides you 70-80% symptom relief is ideal, everyone is different. However, I started on the .025 weekly years ago and bumped up to .05 after a different menopause doctor said that .05 was the minimum dose required to receive bone, brain and heart benefits. Eventually I increased to .075 which has really provided better symptom management (for me). I have the Mirena IUD so upping my dose was not an issue (didn't have to worry about increasing my progesterone dosage or spotting, etc).
My IBS-D intestinal cramps got 100x worse with the Estradiol 0.5 mg patch and I had to stop. Not even high doses of Hyoscyamine stopped the cramping. It was awful and I was so sad to quit the patch bc it made all of my other symptoms go away and I felt so much better. How can I use the Estradiol patch and not suffer with severe IBS bc I'd love to get back on it (had a hysterectomy in 2008 due to a 10lb, soccer ball sized uterine fibroid. My Gyn left my ovaries and cervix). Thanks!
Hi, have you found any form of estrogen that doesn't cause cramps ?
@@sabrinasantiago4391I’m wondering too. I’ve been on the Combipatch since March and suffer from terrible cramps and bleeding. Worse than when I was menstruating
Anyone use self tanner while using estrogel? If so what is your order of application process? Do you just put on over an hour after estrogel?
I'm wondering about the comments that patches might not be the best option for people who are big hot tub or sauna users. I have been on the weekly patch for many years but have recently been going to water classes 2-4 times a week at my local hot springs pool. I've wondered if this could really mess with absorption of the estradiol related to what the hot water does to my skin - perhaps opening pores, etc. I've recently had my estrogen level tested and it was very high - 257! I'm interested in any thoughts!
The patch will not work if you are a swimmer.
Put a nexcare water proof bandaid over the patch. It works
Can estrogen cream cause further irritation? I’ve been suffering for a while now taking the patch 0.0375 and started using the cream two weeks ago. Yesterday I was feeling fine yet I applied the cream and today I’m irritated 😢😢
I was on hormone replacement 15 years ago for 5 years then phased off them. Now I’m interested in revisiting hormone therapy but have read that it’s too late for me to start again. Is that true?
My OBGYN told me I could have hrt for ever. He’s also a specialist in cancer and endo so I trust his advice. I would say never too late , good luck !!
Hello I’m on the 50 patch and 200 progesterone. I change every four days. My breast especially my left is more sensitive . Could this be a symptom that the patch is wearing off ?
She has a video about this. It means EITHER your progesterone OR estradiol dose is too high.
I’m just wondering if I lower progesterone will I bleed?
Anyone have problems with gallbladder on the patch?
Can I use gel as trans woman ? If yes , where can I find this product ?.
Why do you use compounded cream?
I don't think she does
She doesn’t use compounded creams. I think she only offers compounded testosterone as a option. I am a patient of hers and we have only discussed the patch, the gel and oral progesterone.
I was told I need testosterone my level is 5. The dr only offered me pellets. I’m not comfortable with that but I can’t fine another clinician
I see dr Hirsch in person but she has clinicians through tele health. My Testosterone was a 5 as well and she prescribed me testosterone. I haven’t started it yet but it was not covered by insurance but she was able to write a script for a years supply for $400. She is covered in 30 states for telemed she doesn’t take insurance but she has been worth every penny and then some. And pellets are horrible for testosterone. Do not take any pellets, that doctor is unethical because they can prescribe compounded testosterone that is a cream. Your only option should not be pellets. T-pellets are so dangerous and can cause a ton of problems.
Started on the gel, and from day one haven’t felt good. Very depressed and moody. Decided to just keep going, and after about 7 days got excruciating bladder pain. Like the worst uti in the world, but the pain came at the end of peeing, not at the beginning. Also started bleeding, and my whole vagina felt on fire. Stopped the gel, and bladder is still irritated, but, about a 3 instead of a 10 (tested, and no uti). Don’t know how to proceed, but I’m scared! ( I will call my doctor, but she’s not overly helpful)
Sounds like you might need an intravaginal estradiol as well.
Hi, the SAME thing happened with me! Very bad bladder pain with the patch after 3 days had to take it off. What did your Dr say about it ?? & did they give you something else? Thanks❤
As far as liver toxicity goes, is the patch/gel generally safer than the oral form of Estradiol?
Yes!
I found I have to apply my oestrogen patch and take my progesterone at the same time to stave off spotting and bleeding.
You take the pill and change the patch immediately after you apply it? I’m still spotting from time to time 😞
@@jojohn2950 I take the progesterone and then put my patch on. No one told me to do that. I just decided to give it a try.
Thanks, I’ll give it a try 😊
@@jojohn2950 I'm still having spotting from time to time too. What seems to cause yours and what has your GYN suggested? I feel like every time it happens, it makes me incredibly anxious.
@@jojohn2950 if progesterone makes you sleepy remember to account for that and consult with your D.r etc etc
Video is blurry
Not for me
The gel works better for me but my insurance won’t pay for it.
How do the dosages compare? .1 patch and 1mg gel are not the same.
Don’t like patch switch to gel
Where is the PROOF that HRT is safe? I am particularly concerned about going on any HRT because I am heterozygous Factor V Leiden. I want proof by way of studies and not just someone saying it’s totally safe. Thanks!
I just started the patch, does that mean I can’t do hot tubs or saunas ?? Booo
You can put on one of those wound patches. Tagaderm. That keeps the water from the patch. I also heard saunas amp up the patch because of the heat. But not 100% sure on that. I just switched from patch to gel for the summer