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[lubylou]

Does anyone have any idea about the equivalent patch strength for Premique low dose? I am thinking about asking my GP to change from these tablets to a patch. To be honest with you I am a completely naive about HRT preparations but I am thinking maybe the patches are better as you get older and have less progesterone and that oestrogen only are better HRT preparations as one gets older. Sorry if this sounds like a stupid question but when it comes to HRT I am a bit thick, when I was given HRT I wasn't told and did not know it simply postponed the symptoms! Yes I am that naive but learning a lot here on the forum and website as a whole.

Your input would be much appreciated.
Ta
Lubylou   

[Hurdity]

Hi lubylou

It is difficult to compare preparations because of the wide variation in absorption - and what levels of estradiol get into your system by the different methods, but a good guide is what it says on this website under the HRT preparations.

If you look at the menu on the left ( HRT preparations), under post-menopause there is only one dose of combi patch which delivers 50 mcg estradiol per 24 hours.
http://www.menopausematters.co.uk/postmeno.php

However if you look at the separate oestrogens page, you will see that low doses are classed as 25 or 37.5 mcg.
http://www.menopausematters.co.uk/treatafter.php

I understand that equine oestrogens ( as in Premique) are quite potent - a mix of different oestrogens, so I would tend to go for the 50 mcg with a separate progestogen if that's what you would prefer, or one of the two combi patches (first link - scroll down). The different progestogens have different effects on each woman so it would be a question of trial and error.

Of course you are not thick! There is a lot to find out and some of us have been doing it for years!!

If you have a womb then you must take progesterone too, to ensure the lining does not thicken - but if you keep within the prescribed limits you will probably be fine and your doc ( hopefully) can advise if clued up!

It doesn't just postpone symptoms - it is also helping to ensure you stay healthy in many ways while you are taking it, and you can't take that away ie the years of symptom free good health.

Hurdity x

[oldsheep]

I was on Premique low dose for 9 months, then gel, then oestradiol tablets (1 a day), then finally patch. They started me on the 50mg (or is it mcg?) Evorel patches, one patch twice a week. Don't think there's an exact equivalent dose; just have to work out what works for you symptom wise I think.

[lubylou]

Thanks for the replies, although I have been taking HRT for a while I am ignorant of all the different types. I was put in Tridestra initially, then on Tibolone but I had breakthrough bleeding so I was put back on Tridestra for a very short time/ Then I stopped HRT for a year (of misery) but as I couldn't live with the symptoms my gynaecologist put me on the low dose HRT. My endometrium lining is "thin" according to the ultrasounds I had a few months ago to check I was OK on the low dose. I have been on the low dose for two years ago. I still have "hot nights" and I was hoping that over time these would reduce in frequency and severity so I could gradually wean off. My gynaecologist told me he had a patient who managed on one tablet a week! I have never been offered another type of HRT.

Having joined this forum I realise how little I know about the different types of HRT preparations available, after all it is something which impacts so directly on my/our bodies and overall wellbeing. I don't know how we could get to a place where the patient information about HRT preparations can be presented in "plain English" when it seems GP's are not up to speed and specialist menopause clinic are thin on the ground. Thankfully I have an excellent GP.  This site is the only place I have found which attempts to do explain everything about this important and life changing thing - the menopause.
 
Hurdity
Thanks for all the info, goodness, you have a lot of knowledge. When you say that equine oestrogens are quite potent does that mean they have higher oestrogen effect in the body/system?  It looks like I am asking a question to which there is no real answer as we are all different in terms of how we respond to the various HRT preparations available! I must say I get confused about the different quantities and names like estradiol or estradiol valerate and conjugated estrogens and values of "mcg" and "mg". Maybe I just need to read it all again. I don't want to end up asking for something which puts me in a worse position symptom relief wise than I am now. I just have this feeling that I would be better off with an HRT with estradiol and less progestogen.

Old sheep,
Did you ask for the HRT changes or were they offered to you and discussed with your GP, I don't know what to ask for if I want to change, but from what I have read here the patch is better as one gets older, I am 58 soon be 59 and my "plan" was to come of HRT at 60 ish if I can. But I don't want to "rock the boat" and end up on some HRT preparation which gives less symptom relief than what I currently take!

Thanks to both of you for taking time to respond.

LL

[Hurdity]

Hi lubylou

It is confusing at first! There is such a lot of info out there - but docs should really try to be clued up or admit they don't know and refer you to someone who does!

Estradiol valerate is just a form of estradiol - it is converted to estradiol in the body.

1 mg = 1000 mcg.  Estraogen dose for patches is usually given in mcg, but all the rest in mg and the progestogens also in mg

Conjugated oestrogens are actually conjugated equine oestrogens. Recently the "equine" seems to be missed out - but this is important because it all comes from horse urine!! As far as I understand it is more potent and contains a mix of oestrogens, some of which are foreign to the human body.

If you are that age then perhaps now is the time to change to a patch - but there are only two conti types to choose from (Eovrel and Femseven) and the progestogen may disagree with you.

You could go for what many of us use and that is an estrogen patch ( say 50 mcg) and separate micronised progesterone (marketed as Utrogestan). This is the least risky form of HRT (ie bio-identical, transdermal oestrogen) as you get older - according to the experts.

Hurdity x