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Anyone use HRT as their immediate follow-up to Tymlos or Forteo?
I'm 63 and will finish 24 months on Tymlos six months from now. At that time, I'll have 6 final months on my commercial insurance before starting Medicare.
I'm one who is probably above-average motivated to delay using a bisphosphonate to "lock in gains" for as long as possible. I don't want to do it anytime soon because I feel like a lot of changes are afoot in this field and best practices are evolving to where more and more people are going to be "allowed" to stay on anabolics past 24 months. That excites me and I don't want to do a bisphosphonate and then dampen the future efficacy of any anabolics I might be offered.
Anyway, I've been researching new-fangled approaches to drug selection and sequencing for my impending "24-months-on-Tymlos-is-now-complete" phase. Working hard and smart on a Prior Authorization for Evenity after Tymlos intrigues me as one possibility as does the use of late-start (11 years after menopause) HRT alone for my next phase.
When we touched on possibilities for this next phase (as we often do in my appointments) my endo caught me off guard because we had just gone over extra lipid testing I had done (APOB and LIPO(a) ) and when I asked him how he was "feeling" about the eventual possibility of using over-60, late-start HRT for locking in gains he said "I have no problem with HRT for you-- your LIPO(a) is near 0 and your other numbers look good. Why do you want to wait till you're done with Tymlos? Why don't you start now and get the benefits of HRT now?"
This was a 20 minute appointment and time was up and the nurse came in and I got whisked away to get my A1C checked or some such thing. I told him I had a lot more questions and would make a longer appointment very soon--he said great/good idea, that he always forgets I'm one of his only patients who does her own research and has her own ideas (?!) and he welcomed the discussion. He said he was calling in .025 patches and 100mg micronized progesterone that day, anyway, so that I'd have them available if I decided I want to get started now.
TLDR: I believe there a couple of you on here who are using HRT as your Tymlos or Forteo or teriparatide follow-up regime... (?). If so, did any of you get started on the HRT while on the home stretch of your anabolic? Or did you wait till your course of Tymlos, Forteo, etc., was complete?
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@lp30
I started out using the weekly patch at the time I was still on Tymlos. Those things are huge, so I did use my rear for those. When I was able to change to the twice weekly patches, those are very small so I just rotated those around my abdomen and shot elsewhere. Usually shot up and down and middle on the opposite side of the patch. I switch the patch from left to right side, so then just did the opposite side for the shots. When the patch was in the middle I could use both left and right sides for a few days. I change the patch on Mondays and Thursdays, so really everthing got rotated around quite a bit. Hope this helps and makes sense! Good luck!!
Nonna
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3 ReactionsI am prescribed Forteo, and I am waiting for my transdermal estradiol/HRT. To arrive at my pharmacy, seems we have a shortage in these patches. I am planning to start HRT and see how I adjust to it, maybe in about 2 weeks, and then start Forteo. I believe HRT will be supporting the gain from Forteo. I am also not a good candidate for biphosphonates.
@lp30 Hi girls, I put my patches along my lower panty line, leaving the belly for shots. Have tested my estradiol levels and this seems to be a good spot...good absorption.
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3 Reactions@psmnonna Can you ask to switch to the smaller patches that you change twice a week? They are very small..smaller than a postage stamp.
@michieg Thank you. I think my problem is my injections; I do all of those along the panty line. Up higher always leads to bruises and blood spots- I don’t have abdomen fat which seems to make it harder! Don’t know what I’m doing wrong.
@michieg
Yes, I did that after about 2 months. I requested the bi weekly patches and my gyn was fine changing my prescription to those. Much better and now that I'm finished with Tymlos I don't have to strategically pick a shot site anymore!
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1 Reaction@lp30
I always seemed to have bruising and blood spots no matter where I shot myself. I guess it's part of the hazards for some of us. I'm sure not everyone has this problem. (Maybe a lot of surface level capillaries??) There are smaller gauge needles that you can request from the pharmacy with your monthly Rx refill, which I did. But I just resigned myself to invest heavily in alcohol wipes and spot bandaids over those 2 years.
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2 Reactions@md79 There is a world wide shortage of estradiol HRT transdermal patches. It could take another year before the shortage is resolved by manufacturers increasing production. You might want to talk to your pharmacy about when they really might be able to get a supply and/or your doctor about alternatives. I heard that estrogen creams are available and might be a good temporary, although messier, alternative
https://www.cnbc.com/2026/06/26/estrogen-patches-are-in-short-supply-as-women-seek-menopause-support.html
EXCRPT: "Estrogen patches are in short supply as demand for the menopause medications skyrockets, and it could take at least a year for manufacturers to catch up."
https://www.ashp.org/drug-shortages/current-shortages/drug-shortage-detail.aspx
The Estrogen Patch Surged in Popularity. Now It’s in Shortage. 2026-02-26
https://www.nytimes.com/2026/02/26/well/estrogen-patches-menopause-treatment.html
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1 Reaction@kfhoz Thank you so much! Yes, my CVS pharmacy did not have it, but I was lucky because a small pharmacy at Safeway had it without my insurance coverage for $ 48 per month. I started it today, and my Teriparatide/Forteo will arrive next week. I am a bit nervous about Teriparatide. I was scarred and torn between going naturally and starting medication, and I chose to go with Teriparatide because of a vertebral fracture.
@michieg My twice-a-week patches are also very small, but I think it has some benefits to have more space for shorts to alternate sides.