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Menopause

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Gel vs patches

5 replies

Mendeleyev · 21/02/2019 09:36

I am going to the doctors tomorrow and I am determined to come away with hrt! I got given antidepressants about 9 months ago but I have other symptoms now so would like to give hrt a go. I know I need to ask for body identical and need both oestrogen and progesterone as I am still having periods. Any thoughts about whether gel or patches better for the oestrogen? Any thoughts about progesterone? I think I could have it prescribed so I only get a period once every 3 months. Yippee! Any advice welcome. 😃

OP posts:
JinglingHellsBells · 21/02/2019 10:18

I think it's down to personal choice re gel v patches.
I've always used gel as it's what my consultant suggested first and I've been very happy with it. (There are 2 types- Oestrogel and Sandrena.) I'd suggest Oestrogel as Sandrena evidently takes longer to dry.

Patches- some women like them but I simply didn't want the sight or feel of a patch stuck on my bum or have issues with them sticking.

The other bonus of gel - and it's a main one- is you can adjust the dose yourself, so although the starting dose is 2 pumps, you can start with 1, and go up to 4 (to get symptom control.) You don't need to see your dr to increase unless they tell you to stick to a low dose for some reason.

There aren't many choices GPs can give you with the progesterone- if you want body identical it is micronised progesterone. This is a capsule. You swallow it but in Europe many women insert it vaginally to avoid some of the side effects. It's not licensed in the UK for vaginal use for HRT for some weird reason, but- who's going to know :) ?

I doubt your GP will allow you to have a 3-month cycle on this.
The usual regime is monthly.
The only people I know who are on a long cycle are - by and large- doing it through a consultant, privately, because if there are any issues with odd bleeding (which can sometimes happen on long cycle) the consultant can refer them for a scan (privately and the cost is anywhere from £100 to £350 depending on who does it and where.)

There is a slight risk of endometrial thickening with long cycle which is why your GP is unlikely to a) even know about long cycles and b) will not in theory prescribe it like that.

You could- and this is not advice from me- stretch your cycle to maybe 5 weeks or 6 weeks, if they approve, once you've been using it for a while.

My own experience is I was on a 3-month cycle for some years. I did get some break through spotting and had scans- not sure if it was the HRT or late periods.

I now use a 6-8 week cycle but that is privately.

Hope this answers your questions! :)

Mendeleyev · 21/02/2019 10:25

Hi that’s great thanks. Very useful, especially about the variable dose with the gel.

OP posts:
scottishdaisy · 21/02/2019 10:41

My GP prescribed patches for me a couple of years ago - but I didn't get on well with progesterone bit of the cycle. Went to a consultant who recommended the Mirena coil and oestrogel but it didn't work well for me - I was anxious and weepy again (although not 100% sure that it was the gel - could have been the coil!). I do think it's down to playing around with what is right for you - I'm back on Evorel 50 but I cut one patch into 3 and so am using 1 1/3 patches each time - changing them every three days. The consultant definitely prefers the gel but I'm sticking with patches although gel would have been better if it had worked! More excitingly.. the consultant has now prescribed testogel, too so am hoping that will help me get a bit more oomph. Good luck with whatever you go for - and just persevere and change things around if you're not happy...

Crosby87 · 05/06/2023 15:06

Been on HRT patches for 9 months, but started bleeding and waking up with migraines every morning, should I change to Gel

WhereAreWeNow · 05/06/2023 18:32

It's really down to personal choice. What works for one woman might not work for another.

I started on patches and the Mirena coil and got on fine. I then decided to try gel because I thought it would be good to be able to vary the dose but it was disastrous for me. My mental health nose dived and my breasts were excruciatingly painful and swollen. I couldn't sleep at all. I gave it about a month and then switched back to patches. I've been on Evorel 100s ever since with no problems at all.

I think you just have to try things out and see how they work for you. If it doesn't work, don't assume HRT isn't for you. Just try a different type.

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