1. < Osteoporosis & Bone Health

Transdermal HRT

Posted by vkmov @vkmov, Oct 19, 2023

Many studies have found that transdermal HRT protects and builds bone without all the horrific side effects of many first-line osteoporosis treatments. The patch bypasses the liver and thereby avoids the risks of breast cancer, strokes, etc. Has anyone explored this or discussed it with their doctors?

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

gravity3 | @gravity3 | 12 hours ago
In reply to @gravity3 "I have had a hysterectomy. My cocktail includes estradiol patch currently .0375 but will go up..." + (show)
@gravity3

I have had a hysterectomy.
My cocktail includes estradiol patch currently .0375 but will go up a bit more, progesterone, testosterone pellet and estradiol cream to be used vaginally.
Yes, less brain fog, more grounded, terrific increase in libido.

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She started me on.025 estradiol patch be cause I had not had any hrt treatment decades.

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vkmov | @vkmov | 5 hours ago
In reply to @mayblin "I just realized and wanted to add some more info. You probably know that micronized progesterone..." + (show)
@mayblin

I just realized and wanted to add some more info. You probably know that micronized progesterone is added to the mix of E2 for those who still have a uterus to minimized the risk of uterine lining hyperplasia. Your obgyn would know if you need progeterone in your case.

This link which @gently provided is very useful in that it's a compilation of users' data for women older than 65:
https://journals.lww.com/menopausejournal/fulltext/2024/05000/use_of_menopausal_hormone_therapy_beyond_age_65.3.aspx
Table 3 and 4 summarized risk reduction or increase based on:
Estrogen alone
Estrogen + progestin
Estrogen + progesterone
Then by type of Estrogen, route and dose.

If one uses E2 alone, the adjusted hazard ratio looks very favorable in many risk categories. Hope these info are somewhat useful to you also if you haven't read them.

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SO helpful. Thank you so much!

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vkmov | @vkmov | 5 hours ago
In reply to @drsuefowler "@mayblin, I'm glad you were able to get the evaluations you needed to safely take estrogen...." + (show)
@drsuefowler

@mayblin,

I'm glad you were able to get the evaluations you needed to safely take
estrogen. I currently have 3 endocrinologists, the only 3 in this area. One
actually gave me a 1mg estradiol tablet prescription, but that is not what
I wanted. He didn't even ask about the uterus. He didn't even listen to me
when I asked about bioidentical estrogen. I still have a cervix so I think
I am supposed to take progesterone with estrogen. The other two (who are
more competent) are firmly against it. I think I would be more comfortable
with evaluations by other specialists. Unfortunately, the cardiologists
here are so busy that so far I haven't been able to see one. So far, every
time I ask for a referral, I don't get one. I can see a gynecologist. My
PCP asked me to sign a release to one of my endos in response to my
estrogen request. I will see him in 2 weeks to find out what he thinks.

Thanks so much @mayblin for your input. I always appreciate what you write
on the Mayo thread.
Sue

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Same reactions here from docs. I think until the FDA takes the black box warning off we may continue to get these responses. One rheumatologist said these recommendations came to them from professional organizations who looked at all the available studies so "we're not going to make that decision in this room."

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sonodeka | @sonodeka | 3 hours ago
In reply to @kper "My gyn reluctantly agreed to prescribe transdermal estrogen (.025) and micronized progesterone (100). I'm 63, menopause..." + (show)
@kper

My gyn reluctantly agreed to prescribe transdermal estrogen (.025) and micronized progesterone (100). I'm 63, menopause at 51, so I'm out of the traditional "window". She said she would NOT agree to increase the dose because there is not enough evidence to support any bone health evidence (yet) on people my age.

For those of you who have started HRT out of the standard window (like I am), did you find physical benefits from this low dose (less brain fog, less musculoskeletal pain, better sleep, increased libido, etc)? And how long did it take to notice these benefits? Any negative side effects?

Are there any tests that should be done while on HRT to check for possible negative side effects, such as increased risk of stroke, blood clot, etc?

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My OP doctor has been very flexible with my HRT prescription, maybe because she's using HRT herself. She started me on what she said was the studied OP therapeutic dose of .05 patch plus micronized progesterone. I felt the effects mildly at first, but after a few weeks had a big increase in breast tenderness. I then asked for a lower dose and was using a .025 patch. The tenderness totally subsided, and I wondered if I could handle a bit more, so after 6 weeks I am now on an .0375 patch. It remains to be seen if the tenderness returns.
I notice the effects mainly in increased libido....sometimes I feel I'm in the film "Awakenings," waking up in a previous life, after a huge menopausal decrease. It's great, but also a bit unnerving at times. I also have been more emotional, but have always been going some stuff so maybe it was bound to happen anyway.
I also use vaginal esterdiol twice a week which helps keep tissues healthy.
As for my bones, I'm doing everything I can in terms of nutrition and exercise and really hope the HRT accentuates my efforts. I have no dexa feedback so far. I am 64, menopause at 53.
Thanks to all of you for sharing and best wishes to us all.

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kper | @kper | 1 hour ago
In reply to @mayblin "I just realized and wanted to add some more info. You probably know that micronized progesterone..." + (show)
@mayblin

I just realized and wanted to add some more info. You probably know that micronized progesterone is added to the mix of E2 for those who still have a uterus to minimized the risk of uterine lining hyperplasia. Your obgyn would know if you need progeterone in your case.

This link which @gently provided is very useful in that it's a compilation of users' data for women older than 65:
https://journals.lww.com/menopausejournal/fulltext/2024/05000/use_of_menopausal_hormone_therapy_beyond_age_65.3.aspx
Table 3 and 4 summarized risk reduction or increase based on:
Estrogen alone
Estrogen + progestin
Estrogen + progesterone
Then by type of Estrogen, route and dose.

If one uses E2 alone, the adjusted hazard ratio looks very favorable in many risk categories. Hope these info are somewhat useful to you also if you haven't read them.

Jump to this post

This is so helpful! Any studies on using MHT and vaginal estradiol at the same time?

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