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[Anjia]

Thankyou Dana I have come to the conclusion that you are probably right about the tablet I have IBS and after reading on this site many times that the patch is better the pill I did try the patch and must admit the IBS did seem to settle but that was all, the flushes and night sweats came back three fold in   future I will stay on tablets the swapping around just makes problems worse.

[Briony]

It's all so confusing. It's frightening how even our doctors give us different facts. For instance:

http://www.menopausematters.co.uk/forum/index.php/topic,25243.msg386811.html#msg386811

(Remember to divide by three to account for the three days of patch).

This is near enough what my doctor said too. I was on 50mcg patch and needed more so she suggested to double it, to either a 2mg BCP (which is what I did) or else a 100mcg patch.

I think it's best to conclude that we're individuals and absorb things differently. For me, the 2mg pill is massively better than the 50mcg patch as it is more controlling of my symptoms.

[Hurdity]

Also to clarify re that earlier post you referred to Briony - it's completely wrong so not sure where the info came from ( ie re the dividing by 3!). A 50 mcg patch is designed to deliver estradiol into the bloodstream at the rate of 50 mcg per day ( OK there will be variation depending on the woman) so it is irrelevant that Estradot and Evorel contain a different total amount of estradiol - they work in different ways but are designed to deliver approx the same dose of oestrogen!

Whatever the biochemistry of it - Anjia - the fact that your flushes have returned shows that you are absorbing more estradiol from the 2 mg tablets than a 50 mcg patch. Your doc should not refuse to increase your patch size for this reason as you are still experiencing symptoms - because women are so variable. It also takes the body a while to settle - obtaining estradiol form a different source.

Transdermal HRT is definitely recommended for women with stomach problems and for women over 60 so personally I would persevere (with transdermal). As I think others have said - if you used gel you would be able to tweak the dose more easily. However I see you need to use what works best for you and what eliminates your symptoms, but your doc should not dictate to you what you need in terms of dose - if you still have symptoms - how assertive are you feeling?!

Hurdity x

[Anjia]

To be honest Hurdity I am not feeling very assertetive at all these days just fed up ,I really did try to explain to my gp but all she kept on about was the fact that I have been on hrt for three years and because of risks she wants me to start reducing it there was no way she would give me a higher patch I did ask .

[Hurdity]

I don't know what to suggest unless you can find another doc in the practice who is more sympathetic or if you can take someone with you? The other suggestion would be to have an e-mail consulation with Dr Currie - costs £25 - which you could then print out and take to your doc - you would need to explain your history, your wishes and the response from your doc and perhaps what outcome you would like if she recommended it -eg a higher dose patch and remaining on HRT? The info on how to do this is on the home page of this website.

I did this myself when my doc recommended I came off HRT prior to an investigation. Once I'd got the answer (that I didn't have to stop HRT) I printed it off and went to a different doc in the practice ( I can't argue with my doc because she doesn't like me because I know more about meno/HRT than she does - she hadn't heard of Utrogestan when I requested it!). It was all fine - the different doc agreed and continued to prescribe the HRT and referred me for the investigation.

Hope this helps.

Hurdity x

[Briony]

Hurdity, I too questioned the info in the link - I should have made that clearer! I posted it simply to illustrate the confusion/misinformation.

My doc did suggest that a 2mg pill was twice as strong as a 50mcg patch, but I am happy to accept this may or may not have been accurate. What is valid is the fact I felt so much better with the 2mg pill.  I think (?) this is what is suggests here too, but apologies if I am wrong:

http://www.earlymenopause.com/hrt_equiv.htm

To add to the confusion, I think one of the many reasons I felt so much better was that on the patch, I had 12 days of progesterone and then horrible withdrawal effects. At least with the pill the dose is slightly more consistent (as it's a BCP).  If I ever went back on HRT, I'd ask to take 100mcg patch (which was suggested as an equivalent to the 2mg pill) but I'd try to take the Utrogestan for days 1-25, if she'd let me.