Just wondered if anyone takes a patch above 100mcg? Saw my GP today to request moving to the BCP as I know I feel best when ovulation is suppressed, but feel the current pill I take is too low (2mg and bio identical, so less potent than standard BCP). I had been encouraged by the positive results other ladies on here in peri menopause are having with the pill. Unfortunately I got a refusal from the doctor as I am too high a risk (family history of early stroke and previous migraine with auras).
She did, however, suggest taking a higher dose patch (100-200mcg) to suppress ovulation, along with either a Mirena or Utrogestan. Initially I thought this sounded incredibly high, but having started to research, it seem to be a possibility and is certainly less of a risk if delivered transdermally. I took Evorel 50 nearly a year ago but, being in peri menopause, it resulted in horrible fluctuations. Felt much better on 2mg estrogen BCP.
- Just wondered if anyone has already tried it? What were your experiences?
Thanks so much,
B x
https://books.google.co.uk/books?id=zAAep7DO9D4C&pg=PA122&lpg=PA122&dq=patches+ovulation+suppression&source=bl&ots=HUNJoEyLk7&sig=G9yh-hOGHb2EkzT4K082deSrrCc&hl=en&sa=X&ved=0CFkQ6AEwB2oVChMI0qnD7tLBxwIVw7UaCh0FOQnK#v=onepage&q=patches%20ovulation%20suppression&f=falseThe first information concerning suppression of ovulation
came following the use of oestradiol implants for
menopausal and perimenopausal women. It was noticed
that the cyclical depression and other symptoms associated
with the menopausal transition were also removed. It
was a logical step to extend this treatment to the younger
women with PMS. Initially, 100 mg implants were used, a
dose that would be regarded as excessive now. A randomized
placebo-controlled trial over 10 months showed
an improvement in all of the Moos' clusters of symptoms
in the active preparation in spite of a small placebo
response in 94% of patients.13
As such long-lasting implant therapy would be inappropriate
in the younger women who may want to
become pregnant, the study was repeated with transdermal
patches 200 mg twice weekly and shown to be
effective against severe PMS in a placebo-controlled
cross-over trial.14 A comparative study was also performed
using 100 mg patch in case there was concern about
dosage that was also found to be as effective.15 There has
not been a scientific study on using oestradiol gels but
this route does produce plasma oestradiol levels similar to
those found with the patches.
Currently, the preferred treatment is by transdermal
estrogen gels, which do not produce the same skin reaction
as the patches and can be discontinued more readily
than the oestradiol implant.
The doses of gel would be approximately 1.0–3.0 g
daily. For example, Oestrogel 1–3 measures a day or
Sandrena 1–3 1 g sachets daily. If using a patch, 200 mg
twice weekly is the usual dose. This dose will stabilize
plasma oestradiol levels to 300–600 pmol/L and the
progestogen levels will remain below 5 ng/mL strongly
Q4 suggestion anovulation. In spite of the invariably low progestogen
in the 100 patients investigated in the study of the
lower 100 mg dose,15 the young women should not be
advised that the therapy is an efficient contraceptive and
that they should use other methods. Patients having transdermal
therapy should be warned that they may occasionally
feel less well in the first two weeks rather like the mood
changes seen in early pregnancy and it may not work in the
first month until ovulation has been suppressed.
