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[Jasmin20]

Hi, I just moved from Evorel conti to Estradot and vaginal prog. Couple of concerns. I just realised the patch I put on two days ago has fallen off! I never had that with the Evorel patch. Do people find them less sticky? Also the vaginal prog concerns me as went to put the second one in and I found the capsule of the first. Are we meant to douche or something before putting the next one in??
Not sure I’ve made the right move here. I have no idea when the ‘dot’ fell off. It’s so small. Any help would be appreciated! Thankyou.

[Traceylr]

hi there,
ive used estradot (50mcg patch) for five years they have occasionally come off but mainly stay firmly stuck. I swim 3/4 times a week and rarely had a problem . Make sure your skin ie really dry, press firmly for 5- 10 seconds .
I also use utrogestan one 100mg capsule vaginally every night no break. Make sure you push it up high as you can . I do find a bit of the ( non absorbable ) shell the next morning , so usually gently flush it
out with warm water as i find it can irritate a bit . This regime has been really successful for me as I dont suffer any of the side effects of utrogestan when using it this way. I couldnt cope with taking it orally as it made me lethargic and depressed.
Good luck and hopefully it’ll work for you .
x

[menomummy]

How are you finding the switch from evorel sequi to the estradot and utrogen, is it helpful?

[Wrensong]

Hi Jasmin20, I find Estradot patches stick extremely well, so much so that they can sometimes be eye watering to tear off!  I was on Evorel Conti for a few years & found the adhesive weaker than Estradot's, though they never came off either.  Agree with Traceylr about pressing them on firmly & skin must be properly dry, but I press each new one on for 30 secs with the flat of my hand.  I also apply pressure for a few secs after each shower & make sure not to let bath towel friction loosen them.  I've never had one come off or even start to peel at the edges & mine are low dose so very tiny.  Sure you've thought of this but just in case, make sure you're applying somewhere they're not being rubbed by clothing - I wear on mid-butt away from knicker edges.  No moisturiser on the patch area either!

Can't help with Utrogestan I'm afraid - can't tolerate it by any route.

[Jasmin20]

Thanks for replies. Second patch responded well to being held onto the skin for longer. I was so used to the conti slap and stick !! IVe just looked at the ingredients of the Evorel conti and the Estradot and I’m a bit baffled that the Estradot 75 has estradiol 1.17mg and the Evorel conti has estradiol 3.2mg. Does this mean I’m actually getting less estradiol now?? The whole task was to increase the oestrogen component. Does anyone know if this is right or not? Maths was  never my strong point!!

[Wrensong]

Hi Jasmin, agree it's confusing, but have a look at these extracts from the summary of product characteristics of the 2 brands/strengths & you'll see you should definitely be getting more oestradiol from your 75mcg Estradot patch:-

"Estradot 75 micrograms/24 hours, transdermal patch.  7.5 cm2 patch containing 1.17 mg estradiol (as hemihydrate) with a release rate of 75 micrograms estradiol per 24 hours."

"EVOREL CONTI has a surface area of 16 sq cm and contains 3.2 mg of estradiol corresponding to a nominal release of 50 micrograms of estradiol per 24 hours "

Btw I get waaaay more oestrogen from Estradot at any strength than I ever did from Evorel Conti.  On Evorel Conti 50mcg my blood oestradiol was what the Menopause clinic described as "a disappointing 113 - less than half what we'd expect from a 50mcg patch", yet on supposedly half that strength Estradot 25mcg patch it was 185 pmol/L!  And on 37.5mcg Estradot I get close to 300.

I think you should get good absorption given time.  Many women on here seem to get on well with Estradot.

[Jasmin20]

Thanks for your reply. I’m on the 75 patch. Maybe I should be on the lesser one? I’m getting headaches and I never get headaches. Also I’m quite irritable. (Not particularly new, but more than normal). I’m not sure my GP would do levels but I could ask .....if you don’t ask and all that!
I really appreciate your very clear, informative reply.

[Wrensong]

It's a pleasure, Jasmin.  You may not absorb as well as I do, but I'm sure you know standard advice is to wait 3 months for the body to adapt to any new HRT product/regimen unless you're sure it's clearly wrong for you or side effects are intolerable.  As a migraineur I do find changes in HRT can cause headaches, though these have not been severe, always settled after a while & I've thankfully not had a return to full blown migraine since final period nearly 9 years ago.  Even starting Vagifem as my first experience of HRT several yrs postmeno gave me daily headaches in the initial loading fortnight.  Mary G's posts show she's another lady who's very sensitive to changes in oestrogen levels (as regards migraine response).  It's definitely not all in our heads!

I couldn't get my GP to test oestradiol either - I get mine done privately & if you're not long on 75mcg, perhaps a bit soon for a good indication of what sort of levels you'll get on average?  There's some fluctuation over the life of each patch too.

If you feel the 75mcg is really not right for you, you could maybe try cutting your next patch by a third to take you down to approx 50mcg & see whether that feels better?  They are matrix patches so you should still get even release of oestradiol from a part patch.  Then, if the headaches & irritability go but you still feel you really need a higher dose for symptom relief, you could go back up a bit by increasing patch size gradually.  Estradot are so tiny I actually measure mine with a ruler if I need to cut them down!

[jasmine5]

Sorry to jump on this post but I will be speaking to the Menopause clinic tomorrow with a view to changing from Evorel Conti to a higher dose preparation as I’m having some issues due I think, to low oestrogen levels.

I understand that the Estradot patch has more oestrogen than Evorel which sounds suitable for me but what is the name of the vaginal capsule that you have mentioned and do you have any particular problems with it?  I haven’t thought about using capsules vaginally before as I suffer with stomach problems so this may be the way to go. 

[Wrensong]

Hi Jasmine5, if Jasmin20 doesn't see this in time to reply before your appt tomorrow, the micronised progesterone capsules are called Utrogestan.  Putting vaginal progesterone/Utrogestan in the search box should bring up others' experiences if you want to read those meanwhile.  Many women find they get fewer side effects that way, but sometimes it can irritate the genitourinary tract. 

Just to clarify - Estradot patches come in a range of 5 strengths from 25-100mcg, but we all vary in how well we absorb from the different products so it can be pretty much a case of suck it & see.  Good luck with your appt.