Want to ask for transdermal hrt - what do i need to ask for?

[Trewser]

I keep reading that transdermal hrt is far preferable to pills, which can be poorly absorbed. I am currently on 1mg Elleste Duet which I am happyish with. Almost never have hot sweats, but still brain fog, some aches and pains and a bit low. I quite like only taking progesterone some of the time however.

I will need to go armed if i want to change so what are other women taking? Im 53 been taking hrt for 18 months.

You just ask for that! patches or gel but be aware there is shortage of patches at the moment.

If you use gel you need 2 products- gel and Utrogestan (micronised progesterone.)

Not sure what you mean by taking progestogen only- the tablets in the pack all contain estrogen but the ones from day 14 or whatever also contain norethisterone.

I've kind of been wondering this too and considered starting a thread about this. All the podcasts I listen to re the menopause, all the contributors seem to be on HRT gel and I'm wondering why.
I'm on Femoston 2/10mg but taking it as I had an early menopause. My only symptom was I skipped a period at 43, got my bloods checked which showed peri so I started HRT. I have/had no other symptom. Should I ask for gel? Is it better than tablets?

Transdermal is meant to have a slightly reduced risk as it doesn't have to pass through your body first.

You will find a lot of transdermal advocates on MN, but be aware that it doesn't always suit everyone. I had a terrible experience when I tried to switch to patches /Utrogestan. I simply didn't seem to absorb enough estrogen from the patches and ended up on the equivalent of double my tablet dose, with my symptoms coming back at various points. I also reacted badly to the Utrogestan which gave me atrocious migranes and unable to function in daily life!
In the end I went back to my Elleste Duet 1 mg and felt normal again within days.

I think transdermal only has a reduced risk of blood clots though doesn't it?

NormaSnorks thank you Norma, that's really interesting and poor you! Sounds horrendous. Hmmm now I'm wondering if it ain't broke don't fix it. Maybe i could try 2mg duet.

Trump is, I am in the same boat. I take Femoston 2/10, no problems at all, feel normal.
I read that patches are preferable but my gyn and endo say that they only benefit is about blood clots and used by older women.
I don’t know if changing my hrt is a good idea actually.

Not sure if I'm at risk of blood clots. BP on the high side of normal. Just starting a concerted weight loss plan which should bring bp down a bit.

Is it best to be on the lowest dose possible ie 1mg oestrogen rather than 2mg? Or is 2mg more of a breast cancer risk?

The dose of estrogen does not affect cancer risk. You need to use whatever dose is required to get symptom relief. That is 'the rule'.

The risk of BC is thought to be less with micronised progesterone and slightly higher with other types, after 5 years' use.

I would say my hot flushes and insomnia are 95% better. Maybe I'll just stick to what I'm on.

The dose of estrogen does not affect cancer risk. You need to use whatever dose is required to get symptom relief. That is 'the rule'.

I'm not sure that's the case, Jingling? All the advice I've seen has been "the lowest dose and for the shortest amount of time needed to relieve symptoms" and I'm sure I've seen studies that show that breast cancer risk increases with dosage?
Perhaps it is only the transdermal route that is not dose dependant?

Nope @NormaSnorks this advice has been questioned by the British Menopause Society

thebms.org.uk/2019/09/bms-response-to-mhra-recommendations/

Oh interesting- thanks trump, I hadn’t seen that.

I'm sure I've seen studies that show that breast cancer risk increases with dosage?

There has never been any research to prove this- it was a guide created many, many years ago and has since been challenged as the link left shows.

Obviously, no one should use more than they need but there is little point using HRT if it doesn't do what you hope it will as your dose is too low- you may as well stop altogether if it's not controlling symptoms.