Is anyone else a bad patch absorber?

[u/Repulsive_Regular_39]

Is anyone a bad patch absorber?

Hi ladies, after bloodwork turns out i am a bad estrogen patch absorber. My levels are very low with highest dose estradot patch. I had a hysterectomy a year ago so i am not on progesterone. I have terrible anxiety, adrenaline sleep responses, brain fog and cold flashes. I have tried estrogel without relief either. Is anyone here on the same boat? What were your experiences with oral estradiol? Any insight appreciated.

[u/leftylibra]

Hormonal bloodwork is not a good indication that you're a poor absorber. Whether or not the dosage is right for you, or the method of delivery is right for you....is solely based on how you feel overall after a minimum of 8 weeks on that same dosage.

Also, note that oral estrogen tends to dump hormones all at once shortly after taking it, which then quickly drop off later in the day. Oral estrogen can contribute to sudden highs/lows in the day, whereas patches, gels or sprays delivery a more steady, consistent dosage throughout the day.

More: The Truth About Estradiol Levels and Menopause Hormone Therapy**

Highlighted points:

BMI affects estradiol levels

As BMI goes up, so do estradiol levels. The theory is that fatty tissue produces estrone, which is then converted into estradiol. Someone might see higher levels on a blood test and worry they are taking too much hormone, when it's a BMI-related phenomenon. Consequently, they might be told to reduce their dose and then have symptoms reemerge.

Alcohol Affects Estradiol Levels

More than two drinks a day will raise levels

Estradiol levels fluctuate, even throughout the day

Even if we used mass spectrometry and controlled for every other variable I’ve mentioned, estradiol levels fluctuate throughout the day. Again, for someone stuck on a mythical level of 60 pg/mL, what if the estradiol is 80 pg/mL at 8 am and 50 pg/mL at 6 pm? Then what? This scenario can absolutely happen.

One reason for fluctuations in levels with transdermal therapy, like patches and gels, is absorption varies through the day according to skin warmth and activity. This means that checking estradiol levels before or after exercise, or even running to catch the bus, might result in different results.

Are low estradiol levels even a sign of poor absorption?

Even if we knew how much estradiol was being converted back and forth to estrone, if someone used a 75 mcg patch and their estradiol level was 25 pg/mL, that doesn’t necessarily mean they have not absorbed much estradiol. Remember, the estradiol in the blood isn’t the worker bee; it’s the estradiol inside the cell. Low estradiol levels may reflect rapid clearance from the blood and into the tissues, meaning the cells are getting plenty of estrogen, it’s just not hanging around in the blood.

[u/Coontailblue23]

With terrible anxiety, I would take the progesterone anyway. You don't need to have a uterus to take it and benefit from it. Many use it like a sleeping pill.

As far as estrogen goes, I can't comment on oral estrogen except to say I think you are right to consider it. You gotta do what you gotta do.

[u/Ill_Stick9380]

I switched from .1 patch to oral recently, and it’s been way better for me so far. I started on 2mg oral, that seems to be working well and I also take 100mg progesterone at night to help with sleep. I also had a hysterectomy over a year ago. Good luck!

[u/meliem]

Yep. Just started oral estrogen. First day I took it was the first time I didn't have night sweats in nearly 9 months. I tried the patch for months going up to two 0.1 patches at the same time but I still had all the symptoms and levels were low. So my doctor suggested the oral estrogen. I have the mirena IUD, so no additional progesterone.

[u/ms_lifeiswonder]

One thing I do with oral is to split the dose in two, and take it every 12 hours to even it out.

[u/IcyInstruction1259]

I just heard from Dr. Habor? the youtube lady and I'm too lazy rn to find the link, but she talks about the data which shows the benefit of doing oral E, which it is the ONLY thing that'll lower the type of genetic familial Lp(a) which even diet won't seem to bring that down. The oral E brings it way down, much more so than the patch! So, some with high LP(a) might want to switch especially if they have any family history of CVD.

[u/MienaLovesCats]

Yes and it irritates me. Used it for 3 weeks. Before switching to 💊

[u/leftylibra → u/[deleted]]

Just fyi, in sharing your gifted link, we can see your name.

[u/80_mph → u/leftylibra]

Yikes! Definitely not my intent. Thank you for bring that to my attention🙏😉