Tablets or patches?

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Hi there, I have been taking elleste 1mg combi for approx 3 months now and although I think I'm feeling a bit better there has been no significant improvement in my low moods. I have been researching and it seems that I may need a higher dose of oestrogen and many of the articles I've read have said that patches or gels maybe the better option?

Has anyone had experience of both types and what are your thoughts? Thanks so much

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  • Posted

    When I first started HRT, I started on tablets.  I found these made me feel queasy and changed to patches, which I've used ever since.  I also found that after a few months, I needed to increase my dose, to totally get rid of my symptoms.  Personally speaking, I prefer patches - they are convenient, unobtrusive and give a continual dose of hormones.  There is also some thought that patches (and gels) have less risks in terms of blood clots and strokes, than tablets (see the NICE guidelines)  - but these risks are very small anyway and shouldn't put you off tablets, if you prefer them.  I haven't tried gels - I don't remember these being an option when I started - but they do seem another good option. 

    Which method you choose is really a matter of preference but if you feel you need a higher dose, I'd speak to your doctor.

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  • Posted

    You sound as though you just need your dose increasing. It's not strictly true that patches and gel work better because they are just giving you the same dose via a different way, in fact tablets start to work more quickly but at this stage (after 3 months) you will have enough of the hormone in your blood stream 
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  • Posted

    Hi:

    When I first started HRT (Prempro) 15 years ago I had about 1 week of mild/moderate headaches almost daily and a little stomach upset.  Took HRT for 14 years (until I had some bleeding issues a year ago January.  Was off HRT for12 months and was miserable every day!!!!  Hot flashes that got worse instead of better, low libido and generally felt crappy all the time.  After a year of this misery, I found a MD who agreed to let me try HRT again.  Began Prempro again last month and, after only 2 weeks, I have my mojo back!!  No hot flashes at all!!  So happy!!  I did, however, have about a week of mild-moderate headaches again, until my body was again acclimated to the hormones.  No headaches this week.  My MD said that if I start to have bleeding issues again that there are other HRT options available today and we'll try something else.  Just love her!!  Hang in there . . . it gets better;-)

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    • Posted

      Your story is similar to mine nancy. I had a hysterectomy and oophorectomy in 1991 at 36 years old so HRT was prescribed and I took it until last year because one of my GP's thought I should stop. Like you the symptoms of menopause came on very quickly so after having to wash my bedding every morning and being very low in mood and tearful  I thought enough is enough and I went back to see another GP armed with the new NICE Guidelines. I didn't need them she asked me if I wanted to go back on HRT, I didn't need to ask. Life is so much better again. I take Premarin which suits me. Just to add it only took 2 days for the hot flashes/sweats to stop.
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  • Posted

    Well I had the menopause at 47 and I'm 50 now when I had the hysterectomy I was on tablets before it but they didn't suit me but this gel does
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    • Posted

      It's personal choice really. I started off with patches in 1991 but they kept falling off. They are better now though but patches, gel or tablets it's all the same. Hormone(s) absorbed into the body through the liver into the blood stream 
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    • Posted

      Whilst I'm sure the liver imust be involved somewhere in the process, many medical articles mention that patches/gels bypass the "first pass" through the liver which means lower doses are effective - e.g. tablet doses are around 1 or 2 milligrams, whereas patches are typically 25-100 micrograms of active ingredient.  Quote from the US National Library of Medicine - "transdermal dosage forms deliver estradiol directly to the systemic circulation through the skin, bypassing gut and first-pass hepatic metabolism".   Google "Oral vs transdermal: Pharmacokinetic differences" for the rest of this article, if interested.

      I don't think it's a major reason to avoid tablets, if they don't cause you problems but it is worth knowing the difference in how the hormones are delivered to your body.

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    • Posted

      The US National Library of Medicine article that you refer to is American and disregarded by doctors in the UK. I know exactly how drugs are delivered and as I said before all drugs are absorbed through the liver. I am currently on a working group looking at HRT and I have read the articles you refer to but prefer not to use Dr Google
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    • Posted

      I've no wish to argue or contradict you - you give some sound advice on here.  I've found the same phrases on many sites, including NHS ones about avoiding "first pass" effect on the liver and they certainly avoid the gut.  I do avoid dodgy sites when it come to anything medical - it was just that the US site had a good description.  

      The NICE guidance does alude to some sort of difference - quote "HRT tablets (but not patches or gels) are linked with a higher risk of developing a blood clot."  It says the same for strokes.  Not saying these risks are high in the first place but it may be worth taking into account for some people.  

      Bottom line is, all the risks are small and we have the choice, which can only be good.  Please don't take offence, none is meant.

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    • Posted

      That is why women see their GP to ensure there are no contraindications to whichever HRT they are prescribed. The risk of stroke you mention is minute and in the research that isn't discredited the researchers couldn't be sure these women would not have had strokes anyway.
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  • Posted

    I was on the pill & the patch ,I liked the patch better. I had cancer at age 57 & my Dr told me I can not go back on either since I had cancer. I'm 65 now & still hot flashing & moody . I have tried all over the counter products & none have worked for me . Oh how I wish I could g back on Her.

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    • Posted

      Maybe you could try a herbal remedy instead if you explained to them in a herbal remedy shop I once tried a tea which they made up for me it worked for a bit
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