Sorry for resurrecting an old thread but I can’t find one I previously posted about halving patches. The nurse told me to try half a patch as I had started bleeding and had sore boobs. I got my prescription late and so had no patches left for a few days and have now been on half for a week. I feel ok so far. My questions are:
Is there a way of knowing what dose I need and can’t I just have a lower dose patch?
I’m worried about halving the patch as I have read conflicting evidence about doing this. The pharmacist in this link say don’t do it.
https://www.theindependentpharmacy.co.uk/menopause-hrt/guides/evorel-sequi-how-to-use
That can't be the case otherwise small patches with less hormone on them will run out quicker. Also half a patch is stuck to half the area of skin so is not likely to run out quicker. That doesn't make sense at all!! I imagine for example that a 50 mcg oestrogen patch and a 25 mcg oestrogen patch have the estradiol distributed over the patch at exactly the same concentration. Halving a patch won't run out quicker, it will just release less oestrogen ( and progestogen) into your body over the same period of time.
What the pharmacist says in the article at that link is wrong. Look here at an academic paper on the subject:
https://academic.oup.com/bjaed/article/7/5/171/535087Although not talking about HRT specifically the paper describes the charatceristics and properties of matrix and reservoir patches:
"In a matrix patch, the active ingredient is distributed evenly throughout the patch. One-half of a patch will have half the original surface area and deliver half the original dose per hour. "
Even so, halving the patch would be off-licence as strictly speaking, the trials have not looked at the efficacy of that particular dose but I know halving patches is commonly prescribed by specialist judging by what I've read on here, and Dr Currie herself (founder and manager of MM) also endorsed cutting Evorel conti patches off licence ( in post-menopause). What would NOT be advisable (without medical supervision) is to only cut the sequi part of the cycle when you are on Evorel sequi as you would then be maintaining the oestrogen dose suring the first 2 weeks of the cycle but halving the amount of progestogen. (However confusingly because the same Evorel conti patches are used for both Evorel sequi and Evorel conti - this means that the same progestogen dose is given in both regimes, so implying it's not quite so rigid!).
Hurdity x