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?

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tsch | @tsch | Oct 22, 2023

I think it is unfortunate that so many women have been scared off HRT.

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tsch | @tsch | Oct 22, 2023
In reply to @dinah1 "Same here. I am 70 and have taken some form of HRT since early menopause at..." + (show)
@dinah1

Same here. I am 70 and have taken some form of HRT since early menopause at 42. I recently switched from oral to the CombiPatch, within months a slightly elevated liver enzyme dropped to normal and my cholesterol readings improved. I plan to stay on HRT for life.

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It is unfortunate that so many women have become scared of HRT. Nothing is without some risk, but the risk of transdermal HRT is quite small.

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bayhorse | @bayhorse | Oct 22, 2023
In reply to @vkmov "From the American College of Obstetricians and Gynecologists re stroke and transdermal HRT: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/04/postmenopausal-estrogen-therapy-route-of-administration-and-risk-of-venous-thromboembolism “Studies that..." + (show)
@vkmov

From the American College of Obstetricians and Gynecologists re stroke and transdermal HRT:
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/04/postmenopausal-estrogen-therapy-route-of-administration-and-risk-of-venous-thromboembolism
“Studies that compared oral and transdermal ET have demonstrated that transdermally administered estrogen has little or no effect in elevating prothrombotic substances and may have beneficial effects on proinflammatory markers, including C-reactive protein, prothrombin activation peptide, and antithrombin activity. Also, in contrast to oral ET, transdermal ET also may have a suppressive effect on tissue plasminogen activator antigen and plasminogen activator inhibitor activity 2324 25 26 27 28 29.

The Estrogen and Thromboembolism Risk study, a multicenter case–control study of thromboembolism among postmenopausal women aged 45–70 years, demonstrated an odds ratio for venous thromboembolism in users of oral and transdermal estrogen to be 4.2 (95% CI, 1.5–11.6) and 0.9 (95% CI,0.4–2.1), respectively, when compared with nonusers 10. Transdermal estrogen had no increased risk compared with nonusers. Similar results were reported elsewhere 30 31 32 33 34 35 and of particular importance, in women who were stratified for weight 36 and the presence of prothrombotic mutations 37.”

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Could someone please translate this study summary for me??

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3 replies
bayhorse | @bayhorse | Oct 22, 2023

I asked the rheumatologist (who's prescribing my osteoporosis med) about transdermal estrogen, and she told me she didn't deal with hormones and I'd have to make an appointment with a gyn. This surprised me -- the rheumatologist is my osteoporosis doc and I figured she'd know about all possible treatments. My gynecologist is not going to manage my osteoporosis. My question: would an endocrinologist manage the osteoporosis AND be able to deal with the hormone questions and possible treatment?

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2 replies
pennykj | @pennykj | Oct 22, 2023

For those of you using transdermal HRT patches, what brand/kind are you using? I read some reviews and it seems like many women like smaller patches. Thank you.

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3 replies
vkmov | @vkmov | Oct 22, 2023
In reply to @bayhorse "Could someone please translate this study summary for me??" + (show)
@bayhorse

Could someone please translate this study summary for me??

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Transdermal estrogen had no increased risk compared with nonusers.

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1 reply
vkmov | @vkmov | Oct 22, 2023
In reply to @pennykj "For those of you using transdermal HRT patches, what brand/kind are you using? I read some..." + (show)
@pennykj

For those of you using transdermal HRT patches, what brand/kind are you using? I read some reviews and it seems like many women like smaller patches. Thank you.

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Menostar

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tsch | @tsch | Oct 23, 2023
In reply to @pennykj "For those of you using transdermal HRT patches, what brand/kind are you using? I read some..." + (show)
@pennykj

For those of you using transdermal HRT patches, what brand/kind are you using? I read some reviews and it seems like many women like smaller patches. Thank you.

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I used ti use Vivelle dot, but now use the generic of it. I used 2x/week and the patch is tiny. There is less glue with it.

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tsch | @tsch | Oct 23, 2023
In reply to @bayhorse "I asked the rheumatologist (who's prescribing my osteoporosis med) about transdermal estrogen, and she told me..." + (show)
@bayhorse

I asked the rheumatologist (who's prescribing my osteoporosis med) about transdermal estrogen, and she told me she didn't deal with hormones and I'd have to make an appointment with a gyn. This surprised me -- the rheumatologist is my osteoporosis doc and I figured she'd know about all possible treatments. My gynecologist is not going to manage my osteoporosis. My question: would an endocrinologist manage the osteoporosis AND be able to deal with the hormone questions and possible treatment?

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HRT is not just for osteoporosis, and I think a GYN is the doc to prescribe it. I dont think you should expect rheumatologist to deal with HRT. HRT may help bones, but that is not its primary purpose.

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1 reply
tsch | @tsch | Oct 23, 2023
In reply to @bayhorse "Could someone please translate this study summary for me??" + (show)
@bayhorse

Could someone please translate this study summary for me??

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Essentially, this says transdermal patches cause much fewer blood clots when compared to oral ET and may have beneficial heart-related effects.

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