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[Stockport1965]

I started on a patch of 50 and had a blood level of 150. I then had it raised to a 75 patch and 1 progesterone. I bled on that and still only had a level of 175.
GP has now put me on Oestrogel - she said to start on 2 pumps and have a blood test in 1 month.

Is it all dependant on the person as to what absorbs best? I'm really tempted to just go to 3 and be done with it. I can always drop it down to 2 if blood results comes in high??
(I'm trying to achieve 250 as I have osteoporosis)

[Hurdity]

Hi there

Yes it is dependent on the person. Different women absorb differently. Did you try different patches? These are also variable. Also check your skin is dry and free from any sort of lotions or oils, including mositurising shower gel or conditioner that may wash onto wherever you apply the gel ( or the patch). Any sort of creaay or oily barrier could inhibit absorption.

As your oestrogen increasses you may well need more progesterone - if you're taking it daily then 100 mg is the licesned dose but for higher oestrogen doses you may need more than this.

Hurdity x

[Stockport1965]

Hi there

Yes it is dependent on the person. Different women absorb differently. Did you try different patches?


Hurdity x

Only tried evorel. If the gel doesn't do the job then I may try estradot

[bombsh3ll]

Please don't take this as medical advice - I am simply stating what I would do, given that osteoporosis is the concern.

Both my parents have osteoporosis and it has destroyed my dad's quality of life since his spine crumbled. He is immobile and on high dose opiates.

It is not a benign disease and has no good treatment. Osteoporotic hip fractures have a one year mortality rate of about 30 percent.

Contrast this with the absolute worst scare story you have heard about estrogen and think whether you would rather be slightly overtreated, for a month, or remain under treated.

I would take the 3 pumps.

[Stockport1965]

Please don't take this as medical advice - I am simply stating what I would do, given that osteoporosis is the concern.

Both my parents have osteoporosis and it has destroyed my dad's quality of life since his spine crumbled. He is immobile and on high dose opiates.

It is not a benign disease and has no good treatment. Osteoporotic hip fractures have a one year mortality rate of about 30 percent.

Contrast this with the absolute worst scare story you have heard about estrogen and think whether you would rather be slightly overtreated, for a month, or remain under treated.

I would take the 3 pumps.

I have started on 3 pumps to hopefully get the correct amount. My 2nd DEXA results were very good after 18months on the patch, but I know can be better. (I am now classed as osteopenia)
I won't take any bisphosphonates, which GP's just want to push (big pharma!)

[bombsh3ll]

That's great news about your DEXA!

I wouldn't take bisphosphonates either - they are less effective than estrogen and don't have any of the other benefits.

It is obviously different for men, but my dad had been on a bisphosphonate for several years after a wrist fracture before his spine collapsed and it didn't prevent it.

He had no known risk factors for osteoporosis either which makes me feel like I have to be really vigilant about it myself.

[Stockport1965]

That's great news about your DEXA!

I wouldn't take bisphosphonates either - they are less effective than estrogen and don't have any of the other benefits.

It is obviously different for men, but my dad had been on a bisphosphonate for several years after a wrist fracture before his spine collapsed and it didn't prevent it.

He had no known risk factors for osteoporosis either which makes me feel like I have to be really vigilant about it myself.

Bisphosphonates have more negatives, can cause fractures if on them for more than 5years. If you have a 10% frax risk, you can see how useless they are on the chart below.

https://www.nice.org.uk/guidance/ta464/resources/bisphosphonates-for-treating-osteoporosis-patient-decision-aid-pdf-6896787085#:~:text=Treatment%20with%20a%20bisphosphonate%20reduces,fracturing%20your%20wrist%20or%20arm.

Estrogen has many positives for heart, dementia and bones.

[Uma17]

I started on a patch of 50 and had a blood level of 150. I then had it raised to a 75 patch and 1 progesterone. I bled on that and still only had a level of 175.
GP has now put me on Oestrogel - she said to start on 2 pumps and have a blood test in 1 month.

Is it all dependant on the person as to what absorbs best? I'm really tempted to just go to 3 and be done with it. I can always drop it down to 2 if blood results comes in high??
(I'm trying to achieve 250 as I have osteoporosis)

I would also go for 3 pumps. Make sure the gel is dry before you get dressed. A tip if you are going to have a blood test in a month avoid applying the gel on your arms and with your hand to avoid contamination where the blood will be drawn from. Apply on your inner thighs. If you do 3 pumps  do 2 or 1 am and 2 or 1 pm. Some use the lid to apply the gel, I use the back of a spoon.

[Bungo]

That's great news about your DEXA!

I wouldn't take bisphosphonates either - they are less effective than estrogen and don't have any of the other benefits.

It is obviously different for men, but my dad had been on a bisphosphonate for several years after a wrist fracture before his spine collapsed and it didn't prevent it.

He had no known risk factors for osteoporosis either which makes me feel like I have to be really vigilant about it myself.

Bisphosphonates have more negatives, can cause fractures if on them for more than 5years. If you have a 10% frax risk, you can see how useless they are on the chart below.

https://www.nice.org.uk/guidance/ta464/resources/bisphosphonates-for-treating-osteoporosis-patient-decision-aid-pdf-6896787085#:~:text=Treatment%20with%20a%20bisphosphonate%20reduces,fracturing%20your%20wrist%20or%20arm.

Estrogen has many positives for heart, dementia and bones.

That paper is very interesting, really highlights how few people they actually benefit. I don't understand why they show different baseline risks eg 10%,20%,30% for spine. Which is it actually for those who take biphosphonates?

[Stockport1965]

Bisphosphonates have more negatives, can cause fractures if on them for more than 5years. If you have a 10% frax risk, you can see how useless they are on the chart below.

https://www.nice.org.uk/guidance/ta464/resources/bisphosphonates-for-treating-osteoporosis-patient-decision-aid-pdf-6896787085#:~:text=Treatment%20with%20a%20bisphosphonate%20reduces,fracturing%20your%20wrist%20or%20arm.

Estrogen has many positives for heart, dementia and bones.
[/quote]

That paper is very interesting, really highlights how few people they actually benefit. I don't understand why they show different baseline risks eg 10%,20%,30% for spine. Which is it actually for those who take biphosphonates?
[/quote]

When you are diagnosed, they use https://frax.shef.ac.uk/FRAX/tool.aspx?country=9

Your risks increase for instance if you are a heavy drinker, rheumatoid arthritis etc.

If you are 10% risk, to me it's a no brainer to not take. GP's hand the bisphosphonates out as the 1st line. To me it should be diet/weight training and maybe HRT

[Bungo]

 so the 10% etc represents frax score. So if frax score is 10% them out of 100 people only 5 benefit. etc etc.

[Stockport1965]

so the 10% etc represents frax score. So if frax score is 10% them out of 100 people only 5 benefit. etc etc.

yep