Estrogen Patches advice

[dreamer_2.0]

The patches on my shoulders were placed thanks to inexperience on my part. It was suggested by the pharmacist. I'll place them somewhere fattier tomorrow after replacing them. With so much movement in my arms, the shoulders don't seem like an ideal place. As for the patches going somewhere fatty, does that really make a huge difference as injections go straight into muscle? This is ignorance speaking, please be gentle. :P

Thank you everyone for your responses. Like all things online, there is a large mixture of experiences; some good and others less so. My experience over the first 24 hours falls into the latter. The patches are kind of annoying. While they haven't come unstuck from me, their edges have which I've fixed with a couple band-aids. Having to worry about such trivial things like this isn't appealing. But, like most things, it'll get easier with experience. That said, I intend on pressing for injections again next appointment. I've now received word from a few separate people that they are indeed available in Canada, contrary to what my Endo has said.

As an aside, a few of you have mentioned weekly patches being larger than the ones you change mid-week. Wow! Those must have been huge because the mid-week ones I have are already fairly large. Now those must have been annoying!

[becky77]

Glad to hear you had no non-stick issues though your message here is concerning, since I'm coming off pills as they weren't doing it for me. Would you mind elaborating? Send me a PM.

Thank you!

I was on Estradot also, they get some fluff around the edges but they don't move.
Two reasons I've come off patches.
1, Despite 3 times a week since Feb 2014, my E levels have never been anywhere near where they should be, as I said transdermal doesn't work for everyone, skin is a barrier.

2, I was going private, I'm now under the Gender clinic and they have put me onto their own regime. Taking me off Androcur also for an injection, that's primarily because my Prolactin keeps rising, side affect of the anti-androgen.

[Eryn]

A fair number of us wear multiple patches because TS needs exceed that of GGs. Adding to this is less subcutaneous fat on genetic males, something that hopefully will be fixed by HRT.

[Frances]

Like I said, I have been on patches since 2008. I'm also Canadian and used to the conservative medical practices of a public system. Usually, patches size and quantity is ramped up. I was wondering if Dreamer girl was putting on multiple patches following directives or doing it on her own. Estradot come in three formats. If one needs a higher dose, there is no reason to wear two lower doses, for instance. I was questioning dosage, just trying to get more information.

[Badtranny]

If one needs higher dose, there is no reason to wear two lower doses, for instance. I was questioning dosage, just trying to get more information.

Yes,multiple patches at once seems a little unnecessary to me as well. Perhaps it has something to do with having testicles? I think I was on pills prior to the Orchi, so I don't really know.

My prescription is (1) patch (of undetermined dosage) every (3) days. So basically (2) patches a week. Also, all patches aren't created equal. My patches are small and stay stuck like glue, but my roomie's patches are twice the size and wouldn't stick to the business side of duct tape.

[STACY B]

See,, Melisa said it,, I had those generic patches the Bigger ones and they don't stick,, Better off now anyway,, Stick and move is my Moto,,lol,,,

[dreamer_2.0]

@Frances - Two patches at a time, replaced every three days, per instructions from my doctor. As for dosage, we'd have to speak privately for that. The patches are from Sandoz.

[Badtranny]

Holy moly Dreamer. Be sure and tell your doc if you experience any dizziness or headaches.

That seems like a high dosage to me, but I don't really pay that close attention to this stuff ...unless I experience dizziness or headaches. :-)

[Eryn]

Yes,multiple patches at once seems a little unnecessary to me as well. Perhaps it has something to do with having testicles?

Dosage is much smaller for GGs, as the E levels to treat menopause symptoms is much less than that needed for feminization. The dosage for younger women who have lost their ability to produce E is somewhat higher and is the reason 0.1mg patches exist.

Unfortunately, many TG people need higher amounts due to larger body mass, reduced uptake due to less subcutaneous fat, and perhaps the effects of T. To get the proper amount some of us wear two or even three patches.

Since we are using this medication "off label" the Pharma industry has no reason to produce stronger patches.

[Frances]

Why do you keep talking about GG's, Eryn? Melissa (and I) are both post-transition women who have been on hormones for a long time. We don't need a lesson.

Dreamer,
If you doctor thinks it's right, then I guess it is. By the way, you did give a dosage in your response.

[Eryn]

I brought them up because the need for multiple patches was questioned. You might not need a lesson but others who are reading might take your questions as indicating that there is something wrong with multiple patches. There isn't, and endos often prescribe them.

[Frances]

The question was for Dreamer and her particular case, but fair enough.

There is something medically unsound with starting with a super high dose at the onset. The body may react adversely and not absorb the hormones. Especially when changing methods. If the highest dose patch is not enough, then sure, put on as many as needed. But it takes a blood test to know that. The best practice is to ramp it up slowly.

Also, since Dreamer was putting it on her arms, which is against directions, I was wondering if the multiple patch thing was her decision as well.

[becky77]

I was on Estradot, 3 patches a week.
That was three in a week separately, not all three on for the week.
It can get confusing but Dreamer has been wearing a patch on her shoulder, so worth checking if the instructions are followed properly.

Three patches at once seems excessive, I'm not an endo so perhaps that is normal, I've never heard of anyone else wearing more than one.

Is there a cost implication? Are three lower dose patches cheaper than a high dose?
The Estradot I was on if my absorption was as it should be would have put my levels right, should! But three high dose patches at the same time risks overdosing, which is why I wonder is there a reason to have three lower dose rather than one high dose?

That's a lot of stickyness!

[Badtranny]

on the other hand, I started HRT back in 2011 I think, so there may be some new protocols and whatnot.

Maybe they have figured out that mega doses are more effective for the new girls.

[dreamer_2.0]

Holy moly Dreamer. Be sure and tell your doc if you experience any dizziness or headaches.

That seems like a high dosage to me...

No complications, yet. I appreciate your concern. I've read and re-read the prescription label in case I misunderstood it, but nope it says "apply 2 patches every 3 days." There's only one way to interpret that, I think. If I'm wrong, please correct me.

Aren't doses typically higher for those pre-SRS or pre-orchi? SRS is still a ways off, though I have an orchi consultation coming up at the end of the month. Who knows when the surgery will be though.

Dreamer,
If you doctor thinks it's right, then I guess it is. By the way, you did give a dosage in your response.

I did? Guessing that was the higher doses? Figured that number represented the size of the patches as it didn't include MG.

Also, since Dreamer was putting it on her arms, which is against directions, I was wondering if the multiple patch thing was her decision as well.

Forgive me, perhaps you misread the part where I mentioned they are on my shoulders, as instructed. There is nothing I've done in my transition, so far, that's gone against instruction.

[Frances]

You seem a little defensive, which I find odd, because you come here for help and advice. That is the reason post-transition people like me stick around. We are not here to be contrarians or to belittle anyone.

EDIT: I just went back and saw this "The patches on my shoulders were placed thanks to inexperience on my part. It was suggested by the pharmacist." He may be used to nicotine patches, and he is not a doctor.


Since this is the wording in the instructions, the shoulder thing is strange (there are also pictures of the places recommended):

http://www.google.ca/url?sa=t&rct=j&...N6zGEYn5FXl0iw

2. Where to apply the ESTRADOT® patch
The ESTRADOT patch is rounded rectangular.
The buttock is the preferred place to apply the patch. Other
suitable application sites are the sides, hip, lower back or
lower abdomen (see Figure 1). Change the site of application
each time you put a patch on. You can use the same spot more
than once but not twice in a row.

Avoid areas of the skin where clothing may rub the patch off
or areas where the skin is very hairy or folded. Also avoid
areas where the patch is likely to be exposed to the sun since
this may affect how the patch works.

[dreamer_2.0]

I apologize for sounding defensive. I misunderstood your tone which I initially took as being somewhat antagonistic.

You are correct, the pharmacist is not a doctor and may be used to nicotine patches. If that were so however, it's unsettling to think the pharmacist is mixing up medications. Mind you, they are human too. He may have also been confused by discussing female hormones with someone who is physically male. He certainly looked confused.

Regardless, thanks for sharing that info on the patches. Neither the doctor nor pharmacist were particularly informative, though I could have asked better questions, too.

[Frances]

I put mine on my love handles and get great results. I change them after a shower and use a little rubbing alcohol to remove soap residue. I use Solvoplast II to remove glue from discarded patches. They stay put on my love handles. I tried the buttocks, but they kept coming off. I switch sides every patch change.

[dreamer_2.0]

See that's the advice I'm looking for from those who've gone before me. :P

[Eryn]

Three patches at once seems excessive, I'm not an endo so perhaps that is normal, I've never heard of anyone else wearing more than one.

I personally know of two people who are on a multi-patch regimen. I think it is more common for older patients. My instructions read "Apply 3 patches twice weekly as directed." My monthly prescription is 24 patches.

Without getting into numbers, the maximum dosage recommended by the Endocrine Society guidelines would require four of the strongest patches.

Is there a cost implication? Are three lower dose patches cheaper than a high dose?

I very much doubt it. I checked prices on-line and the per-patch price is the same for lower and higher dose patches.

The Estradot I was on if my absorption was as it should be would have put my levels right, should! But three high dose patches at the same time risks overdosing...

As you indicated, absorption varies widely. My endo started me on a lower dose, then titrated me up after my levels were tested. The levels are what create the positive effects. Monitor levels and there is little danger of overdose.

[Frances]

Dreamer and I do pay more for larger than smaller patches, based on governmental drug schedules and inssurance in our country.

[Eryn]

The question is, is the price proportional with the dose? Is a patch with half the dose also half the cost?

[dreamer_2.0]

Just took the first patch off one of my shoulders - OW!!! The stick was unexpectedly still strong. Pulled off some hair too. Haha Two birds with one stone, I suppose. Now for the other shoulder...

A little bit of residue was left after, hardly any.

Next placement will be love handles...though too bad putting them on the chest isn't a good idea as I could get rid of some hair that HRT hasn't dealt with yet.

Had some slight lightheadedness yesterday afternoon, but unsure if from the apparent high dose of the patches or if because I hadn't eaten in a while. The feeling abated after eating, so I'm thinkin the latter. Still, something to be mindful of.

[Frances]

The chest is dangerous for cancer.

[Nigella]

Holly,

I know this may be a silly question, but are you on spiro? And how are your testosterone levels? I've heard transwomen who take estrogen without spiro and don't get much of a result.

This I will concur with, when I first started HRT my T levels were low for a GM, I'm not sure of the delivery methods for AAs, however, the indications were that they would go through the liver and I did not want to put more and more stuff through my liver considering the medication I am already on. I decided, after consulting with my Endo, that AAs were not an option. The E had little effect on growth and fat distribution, but did soften the skin and help with other things like body hair. E was fighting T and slowly gaining, but it was not until after SRS that the full benefits of the E kicked in.

I am on mulitple patches to allow for a specific dose, there is not one patch for the dose I'm on. I wear a large and a small patch, the smaller one being half the dose of the larger one. The quantity of patches worn will very much depend on your individual dose AND whether the brand you use is available in that dose in one patch, or whether you would need multiple patches to make up your dose.