Patch Vs. Oral Hormone Replacement Therapy (HT).. WHICH IS BEST FOR YOU?

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Many women wonder if if the patch or the pill is better, safer, or more effective? Check out this week's video for a deep dive on this question!
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@christinewegner6713 3 жыл бұрын

Love listening to you and your information. It is so informative and has helped me to make decisions for HRT. I started taking the HRT pill about 3 months but was still worried about blood clots even though I am pretty healthy and don't have a history of any issues and have taken birth control for many years. After listening to this I feel more comfortable on continuing on the pill form. I even turned my friend on to you and she loves you too.

@heatherhirschMD 3 жыл бұрын

WOW Christine, that is the best compliment, and I truly thank you! I hope this has helped you as I know firsthand how much it can improve quality of life and wellbeing! You are amazing too!

@titinfatimah7268 3 жыл бұрын

@@heatherhirschMD32

@winning3329 3 ай бұрын

I tried the patch and the pill and I feel like the pill works better. I was still exhausted when I used the patch but when I tried the pill I have more energy.

@jennifermorgenstern5118 3 жыл бұрын

Ohhh love this! I’ve def fallen into the trap of always starting with the patch. Good to hear stats and pros/cons of patch vs oral. Thanks for your videos!!

@heatherhirschMD 3 жыл бұрын

You are plenty welcome! Don't be afraid to prescribe oral. Works wonders!

@diannabentley9363 5 ай бұрын

This was so easy to understand and so helpful! Thank you!

@squirrlee6463 Жыл бұрын

Dr. Hirsch, you’re one of the few reliable sources of female hormonal medicine that I feel comfortable sharing with ‘newbies’. This may seem like a strange comment but please take a look at the YT commercials currently preceding your videos. The one advertising about a ‘menopausal body fat…’ supplement was sketchy.

@helenfearnley2818 3 жыл бұрын

Very interesting info. Thanks

@lizpowell8825 2 жыл бұрын

Very helpful thank you!

@larajohnson8174 3 жыл бұрын

You have no idea what a wonderful service you are doing for women everywhere! Thank you 🙏🏻 a million times over. Very grateful ❤️❤️. Going to take a look at your website for your e-book!!

@heatherhirschMD 3 жыл бұрын

Thank you so much! So kind! You are welcome! Feel free to share my channel :)

@larajohnson8174 3 жыл бұрын

@@heatherhirschMD LOL - I literally just did to another KZfaq watcher, moments before seeing your message!! And rec'd your channel on the menopause forum on mumsnet.

@heatherhirschMD 3 жыл бұрын

THANKS LARA!!

@larajohnson8174 3 жыл бұрын

@@heatherhirschMD Just wanted to add: my MS is switching me from patches (I apparently don't absorb very well!) to oral and I decided to watch your video again for reassurance. I feel much better about the oral route now! XX. Thank you! PS I am now on five different menopause forums on Facebook, and have recommended your channel and podcasts to all of the women there!

@heatherhirschMD 3 жыл бұрын

Hope this has helped Lara!

@deannacrawford9467 3 жыл бұрын

Hi Heather! Thank you for reaching out to women about these important topics! You are amazing! I am taking 1/2 combi patch twice weekly. I had to decrease the patch due to bleeding issues when i first started. My vasomotor symptoms are controlled well for the most part but the vaginal symptoms are not. Still dealing with vaginal dryness atrophy and irritation. Any recommendations? Would an oral combo work better? Would adding vaginal estrogen be an option? Thanks!

@heatherhirschMD 3 жыл бұрын

women can add a local vaginal estrogen product even if on systemic HT. sometimes the vaginal area needs more TLC then anywhere else in the body! vaginal estrogen for the win! Check out my video on vaginal estrogen products.

@amy-dj3jx 2 жыл бұрын

hi, Dr, Love your content! If you have a patient with factor v Leiden, would you avoid transdermal too? I am very healthy otherwise and had 2 normal pregnancies but my mother did have blood clots during her life. thank you!!!

@melodielumley6450 Жыл бұрын

Thank you, it's so hard to figure out what type to take. So much information saying not to take a tablet because of the liver/blood clot aspect. I know nothing is perfect, although I certainly spend all my time searching for it :). This at least makes me not as scared about tablets. I just wish pharma companies would make patches with higher doses as well as the gel. Could be a game changer I think. I have heard that the younger you are (well under 55) the more estrogen you need? What do you think?

@monicaatneosen8524 Жыл бұрын

Dr.Herschel…hello I love your videos on menopause you are so helpful! I am 55 and period stopped one year ago. I began Prempro five months ago. I hear so much about bio identical hormone replacement and I’m just not clear on if that is better or even different than what I am taking? Can you clear that up for me?

@drsm5649 2 жыл бұрын

Would having antiphospholipid syndrome be a contraindication to taking hormone therapy ? Would taking warfarin be a contraindication to taking hormone therapy? Your videos are extremely helpful! Thank you!

@ctine882 3 жыл бұрын

I use the twice a week estrogen patch. It works best for me. I still have some night sweats but not every night. My symptoms are so much more manageable.

@heatherhirschMD 3 жыл бұрын

That is wonderful to hear! I use the patch so often and wow what a difference sleeping makes!

@francescapescehughes7854 7 ай бұрын

Firstly thanks so much for your fantastic advice . Could I ask you please when you mention lipedema a few times . I was just wondering why as I have Lipedema and I’m on the combined evorel patch . I was on estradiol gel with progestin tablet which gave me headaches and also gave me anxiety . The patch seems to be good for me . Best wishes

@lisadoane4647 3 жыл бұрын

Hi Dr. Hirsch! Watching this video has helped me feel more comfortable with starting oral HRT. I have been trying to educate myself on the whole perimenopause/menopause process. My Gyn also prescribed Paxil 10 mg, she stated that studies show it helps with hot flashes and would help with mood swings. I am a little apprehensive about taking this medication. I am interested in hearing your thoughts! You give many women such as my self hope that we will feel “normal” again!

@heatherhirschMD 3 жыл бұрын

I’m so glad! That’s why I do this :) when I consider this combination for women I often start with one first (often HT) then see if you need PAXIL (often one does the trick)

@concettakozakiewicz4176 2 жыл бұрын

If you had a pt whose triglycerides were raised by oral pills would you recommend a switch to the patch?

@laurenbeckerle7977 2 жыл бұрын

Last year I had a full hysterectomy, I’m in my 30’s. Cysts and a jumbo 36 cm suspicious one so they took everything. I’ve been on Premarin, then the femring, and now the patch. I liked the ease of the ring, but I think it was causing yeast infections? Is this something that can happen? I just switched to the patch yesterday so hopefully that stops it. Kinda feeling frustrated trying to get this whole estrogen replacement thing sorted out…since it’s not an option for me not to take anything. My OB wanted me off the Premarin because of heart and liver health. But my regular doctor today, who I saw for a checkup didn’t seem to think that was an issue 🤷‍♀️😑 my on heath issue is Hashimoto’s, healthy weight, back to exercising regularly and eating right since I’ve gotten rid of that stupid giant cyst.

@nelliegirl6238 2 жыл бұрын

Thank you so much for this video! I was put on HRT tablets (2mg) shortly after my complete hysterectomy back in 2018 and then last fall for some reason my OB/GYN suggested trying the transdermal patch 1 mg. I’ve given it a try now for a few months but I’m just not feeling like it’s very beneficial because my hair has become SO dry, I feel like I’m having more joint problems and my sleep is not as good. 😩 I’m seriously considering switching back to the tablets, ( my OB/GYN said there was no problem switching back) but my question is am I going to half to suffer a transition period for it to take affect? How can I make that transition smoothly without a huge hormone drop? For instance, should I continue with the patch for maybe a week while I start taking the tablet?Any suggestions?

@janebirkin1000 2 жыл бұрын

I would for a couple of weeks, introduce the pill and keep the patch running in the background, may be second week cut it in half and taper off that way while oral E2 is being built up to steady state

@mrsh4505 2 жыл бұрын

Thank you for your channel! I have a condition known as angioedema, which was exacerbated by birth control pills (took those several years ago for hormonal acne). Is the estrogen level in low dose BCP the same as the level in estrogen only pills used in HRT? i.e., would there be a low dose estrogen only pill I could take? I am currently using topical gel samples from my GYN, but my insurance coverage is VERY limited as to what I can use and it doesn't cover the gels. I am also taking Progesterone. 52 and post menopause for 2 years now.

@winning3329 3 ай бұрын

Can you give us an update?

@scmommy4539 Жыл бұрын

Is there any evidence that use of Ibuprofen (or other anti-inflammatory meds) decrease absorption of estrogen in pill form? Thank you so much for this channel!❤️

@yvonneg313 8 ай бұрын

Is Bijuva good? I’m on it 2 years now. Love it. Should we stay on this endlessly?

@helenfearnley2818 3 жыл бұрын

I have tablets but i have got acid reflux would patch be better? Menopause and acid reflux started around same time.

@lindasunny3922 2 жыл бұрын

By pill , do you mean troche ? What are your thoughts on torches for bio identical hormones ? Thank you

@paulajonson2827 Жыл бұрын

I'm not obsorbing jel or patches what are my options 🤔 I also have non alcoholic fatty liver, thankyou currently struggling with anxiety and joint pain.

@starrsula2581 2 жыл бұрын

I’m 31, and just a week in on once a week estrogen patch and progesterone, orally. I’ve had an ovary removed and the other ovary isn’t working as it should. I’ve had menopause symptoms after my surgery and now a year later I’m on HRT. Taking as much information.

@sephoramg682 11 ай бұрын

Im 25 years old as and same problem I'm thinking I'm alone

@cami5054 2 жыл бұрын

Hi Dr. Heather thanks for the video ! Do you find any differences in breasts being "full" in patch vs pill since the patch seems to pump up the dose vs the pill which waxes and wanes each day ? Thank you

@janebirkin1000 2 жыл бұрын

I have done both, and I find that the pill gives nicer fullness than the patch. But, you must split your dose twice a day, otherwise you will crush. I feel the dip of the pill around hour 5-6. Patch runs nice and high for one day for me and then it feels too low

@cami5054 2 жыл бұрын

@@janebirkin1000 Thanks for your reply. Will see.

@cm1906 2 жыл бұрын

@@janebirkin1000 Interesting. I wish Dr Hirsch had mentioned the issue of the pill dose possibly not lasting for 24 hrs. Whether that means one should be on a higher dose? She didn’t mention having to split the pills. What I have heard from other menopause specialists is that many providers are timid when it comes to prescribing HRT and as a result tend to prescribe doses that are too low.

@DownHomeMoney 3 жыл бұрын

What are you thoughts on Bijuva? I’ve heard great reviews and it’s bioidentical FDA approved. You should do a video on that. New Sub. Thanks!

@heatherhirschMD 3 жыл бұрын

Bijuvia is an excellent option. It’s “bioidentical” (aka estradiol) AND FDA approved!!

@DownHomeMoney 3 жыл бұрын

@@heatherhirschMD I told my doctor about it and he wasn’t aware of it. Its expensive but hopefully worth it. It’s $269.00 a month and looks like insurance is not going to cover it yet! Hearing great reviews. Are you prescribing it in your practice?

@heatherhirschMD 3 жыл бұрын

@@DownHomeMoney yes but much cheaper is just estradiol 1 mg and progesterone 100 mg. These are generic. The only thing that makes bijuvia special is they just combined them! lol nothing special !!!!

@DownHomeMoney 3 жыл бұрын

@@heatherhirschMD Thank you so much. Look forward to learning from you!

@kl3625 2 жыл бұрын

Is it normal to get a headache when starting estradiol? I’ve had one for a month since starting.I’m on 1mg estradiol. I stopped for a couple days & the headache subsided. I heard it can take up to 3 months to adjust so I wasn’t sure how long until the headache goes away or if I should lower my dose.

@danskdna8550 Жыл бұрын

You can always step the dosage down or up, try it a few weeks. Just ask your dr. The amount you need that is perfect for your body is not exact, often you need to experiment through trial and error. 1.0 and 200 progesterone was too high for me, went to .05 estradiol and 100 progesterone and within a few weeks I felt waaaay better.

@corinaflores4298 Жыл бұрын

Hi I'm currently on climara estradiol patch for 2nd week0.1 its helped me the first we today I had hard time sleeping can a take a progesterone pill with the patch for sleep not sure it's all new to me had a full hysterectomy everything took enough out

@ToniR93301 Жыл бұрын

Hi Dr Hirsch, I am on climara patch for hrt and I wanted to know if I can place the patch on my shoulder.

@emmamaloles2736 Жыл бұрын

Me too climara 50

@meilih2030 Жыл бұрын

I am thinking about side effects, because along time ago I was prescribed diane35 for my acne and it was painful to my legs. I was swelling so I stop. I am not sure if this MHT will be fine with me since I have problem with swelling.

@ellenmeilee 3 жыл бұрын

Thanks for the video...really good, but the answer to this question only starts to be given to the viewer at least half way into it. Time stamps might be an idea?

@heatherhirschMD 3 жыл бұрын

Thanks! And since I’m pretty new to KZfaq this is a really great recommendation so thanks for sending this my way

@flaminproductions6320 2 жыл бұрын

I also have high blood pressure and high cholesterol

@carinsmith1102 Жыл бұрын

Hi there is it common to feel nauseas on patches slabs utrogestan How do we get to make an appointment I HAVE BEE REACHING OUT ON ALL PLATFORMS NO REPLY 🆘🆘🆘

@Nellie7777777 7 ай бұрын

Does calcium d glucarate effect absorption of estrogen from estradiol patches? Is it good to be used as a preventive?

@JesusSaves7012 2 жыл бұрын

Probably useful information but takes too long to get to the point...

@PiggyLovesOllie 9 ай бұрын

Agree :/. Intros are too long

@tinaueland1546 2 жыл бұрын

Hi, just started 2mg estradiol, how long do I need to use before my hot flashes go away?

@winning3329 3 ай бұрын

3 weeks

@ramyaramu7204 3 жыл бұрын

Hi...my mom had BSO with TSH....she is a rhematoid arthrities....Is Estrogen Therapy good for my mom?

@heatherhirschMD 3 жыл бұрын

There are many many benefits for women who take estrogen after hysterectomy, Check out the AHAH website for even more. (stands for advancing health after hysterectomy)

@jennetzel2663 3 жыл бұрын

Hi Dr. Hirsch! Great video as usual! One question I have regarding patch HRT. When you say “some people just don’t do well on the patch” what do you mean by that? I’m currently using.05 estradiol 1x weekly for about 6 months) and while most of my major symptoms have decreased they are not 100% gone ( night sweats for example). I’ve talked to my care provider about increasing dose but she says 75% .is good enough. Do you think changing to a spray or cream might be a better option (in general?) thanks!

@heatherhirschMD 3 жыл бұрын

Certainly that’s a great question in it’s fair to wanna shoot for being 100% clear of your symptoms since you are doing the work of taking medications now sometimes I have a 24 hour does can certainly help with the nighttime symptoms since they are every 12 hours or so and so you could talk to your doctor about switching to a daily transdermal option or even an oral option but certainly start with your doctor and see what he or she thinks thinks

@rowenarogado9337 3 жыл бұрын

Hi Dr, just wondering do HRT patch and IUS works together? Can I only have the patch to alleviate my symptoms

@squirrlee6463 Жыл бұрын

I’m someone who doesn’t do well on the patch. It seems to ‘dump’ all the estradiol at once and the following 3 days I get nothing. The ups and downs were frustrating and probably unhealthy. I work outside and in the summer I sweat a lot , often changing clothes 3 x a day. I’ve never had a problem with the patch staying adhered to my butt cheek though. It’s actually difficult to remove. I’ve been on a compounded estradiol cream for over a year and it works ok until it didn’t. The estradiol cream doesn’t work well at all during this time. Plus it never seems to absorb fully on my thigh and it’s inconvenient waiting to get dressed for a half hour 2x a day. I’m switching to the mist that dries instantly.

@tamiramos5873 7 ай бұрын

With all the side effects, how do you feel ok with doing HRT? I was given Prempro the other day but I don't want to take a pill so I asked for the patch. That's why I am here. But the only difference between you and me is I still have my uterus. I was told initially that if I only have estrogen that I would have my period again. I may be getting the combi patch. However, I am not sure why I am getting anything, my sex drive is outstanding (although I don't get satisfied much), I do not have a dry vagina, I went through hot flashes and if they are still here, I do not notice them. I do want to sleep better though and get this menopausal belly under control. If HRT doesn't help with those two things, I am not sure why I should do it.

@cindysali 3 жыл бұрын

What if you are 18 post menopausal due to cancer treatment and radiation? I’m currently on the patch that a change twice a week

@heatherhirschMD 3 жыл бұрын

What my video on premature ovarian Insufficiency. While that is NOT your diagnosis, many of the principles of being in menopause so young apply to you.

@charleedell92 3 ай бұрын

I used the estradiol patches as an IVF patient and they were forever coming off and bunching up. I had to buy surgical adhesive tape to keep it on. My doctor said they it was because they were were designed for much older women who weren't very active and didn't wash very often 😂.

@rialdapatkovic 10 ай бұрын

I’m 35 years old,going through the menopause, one of my doctors put me on estrogen patches which I’ve been using for over a year and today I had a check up which one other Doctor Who told me I’m at high risk to get cancer because you should never use estrogen patch without progesterone pills, she make me appointment for ultrasound next month and mammogram but just to have weight for four weeks it’s killing me

@winning3329 8 ай бұрын

Unless you don't have a uterus taking estrogen without progesterone will put you at risk for uterus cancer. First doctor is an idiot. I hope you are doing well.

@Anonymous-bq6li Жыл бұрын

I have a question regarding dosing. I tried troches Biest 2mg/40mg/Testosterone but felt like they weren’t working. So new Dr & she isn’t a fan of them, so she changed me to the generic Climara patch .0375 with Progesterone capsules 200 mg. My mood and irritability tanked about 2 weeks after starting patch. Could the dose be too low? I don’t want to have to go on an SSRI, but I’m feeling hopeless. I already take Wellbutrin

@heatherhirschMD Жыл бұрын

Yes the E too low and P maybe too high

@Anonymous-bq6li Жыл бұрын

@@heatherhirschMD thank you!!! 😊😊

@Anonymous-bq6li Жыл бұрын

Thank you sooo much Dr. Hirsch!!!! 😊. do telephone/video appointments. I’m afraid to call my Dr. to change my dose.

@Anonymous-bq6li Жыл бұрын

@@heatherhirschMD 😊

@vickiewells2761 3 жыл бұрын

I was using the estrogen patch of 1 mg. I changedd to oral estrogen of 1 mg. My hot flashes returned but not as intense or as often. Can the oral pill cause this? Does my dose need to upped? Thanks

@heatherhirschMD 3 жыл бұрын

It's hard to say this without seeing you. But yes, that might not be an equivalent dose. I often try to increase 0.5 mg so you could try 1.0 in the morning and 0.5 in the evening.

@vickiewells2761 3 жыл бұрын

@@heatherhirschMD Thank you!

@agquaproductions9361 2 жыл бұрын

The pill when taken orally increases conversion to estrone which is dangerous.

@janmartell9792 Ай бұрын

I had one focyor who only prescribes capsules and one who only prescribes cream. The cream did not work, so I'm back to the capsules.

@flaminproductions6320 2 жыл бұрын

Nov 17,2020 I had everything including ovaries removed,I wish I would have been more educated about the risk of not having my ovaries,I'm suffering from severe night sweats,mood swings anxiety,I was 48 years old,the surgery was due to PCS,,I've been afraid of HRT,,

@KT-ml1sy 9 ай бұрын

NOT having proper estrogene levels into OLD AGE increases your risk of heart disease, osteoporosis, Alzeimers, and All-cause mortality in general. DO YOUR REASEARCH AND GO TO A GOOD BIO-IDENTICAL HORMONE DR. You might have to pay cash as most of the really good ones don't take insurance. DON'T suffer with these horrid symptoms and DON'T risk you future health due to misinformation.

@mayracampos7915 2 жыл бұрын

I live in Waltham and I need a doctor to see me, how can I find a female doctor at the woman’s hospital?

@mommamia29 3 жыл бұрын

What are your thoughts on Birth control for peri-menopause. It helped for a little while and now it’s not.

@deborahc7113 3 жыл бұрын

how do a go about finding a doctor like yourself, who do specialize in mebopause in the new york area. is there someone whom u could recommend. thank you.

@heatherhirschMD 3 жыл бұрын

I Highly recommend the North American Menopause website go to menopause.org and search under find a provider by your ZIP Code

@heatherhirschMD 3 жыл бұрын

Great question and I am going to do a video on this topic of birth control pills into menopause THIS WEEK! should be out on my upload day - FRIDAY!

@kathleentoledo1348 2 жыл бұрын

What about cream over the counter?

@Kate-xc4wn 3 ай бұрын

Is the oral form more beneficial for skin and hair compared to Evamist?

@kathleenbelson9436 3 жыл бұрын

After one year on a 0.05mg/day estradiol patch, I had my hormone levels checked and my estrogen level was

@heatherhirschMD 3 жыл бұрын

If you feel well, then your body might just need a tiny drop! If you are having symptoms then you could increase the dose safely. More is. It better- go by symptoms.

@alisonratchford8375 2 жыл бұрын

Firstly Dr Hirsch thank you for educating women on menopause! Have been on Estradot 75 twice a week and Estradiol is below 200 pmol/l. My understanding is should be between 300-1000. I still feel lethargic, anxious on my current dose. Was reluctant to switch to oral but may give it a try knowing that with my history, I have low risk of clot.

@tanhome7 3 жыл бұрын

My Dr told me bluntly that I can’t smoke while taking hormone therapy. I’d be very interested to hear why this is. He is a dick and didn’t go into detail which was unhelpful for me. You also haven’t mentioned smoking in your videos I’ve watched so far, please expand on this topic and how it increases your risk for a blood clot. In my mind I’m wondering why taking estrogen & progesterone which my body is depleted of (natural things that I used to make in my body but have decreased levels of now) would cause death which is how my Dr put it bluntly to me.

@heatherhirschMD 3 жыл бұрын

Because postmenopausal Estrogen doses are so much lower than birth control doses you can be a smoker and take hormone therapy. Of course best if you can decrease or quit smoking - but this is not a contraindication to using hormone replacement therapy.

@tanhome7 3 жыл бұрын

@@heatherhirschMD thank you kindly for the reply to my comment, much appreciated Dr :) You mentioned post menopause but I am in peri menopause and I’ve never take birth control so is it safe to say that what you said would be also the case with peri menopause if I decide to take hormone replacement-therapy?

@heatherhirschMD 3 жыл бұрын

Yes if it is post menopausal HT.

@MissWeezeyUSA 9 ай бұрын

☝️8.08 Starts to discuss titled content.

@boplop5406 3 жыл бұрын

What are your thoughts on femring and shots?

@heatherhirschMD 3 жыл бұрын

Since injections are not FDA approved and there are several great well-established cost effective and very efficient FDA approved medications I don’t recommend injections and I have a video on why not to use testosterone pellets which might be helpful to you.

@boplop5406 3 жыл бұрын

@@heatherhirschMD woah woah woah!!!!! Estradiol valerate aka delestrogen and estradiol cypionate AKA depo-estradiol are BOTH FDA approved forms of injectable estradiol/estrogen! Where did you get such false information from that they weren't fda approved?! Here are the fda approvals from the fda's website! Delestrogen/estradiol valerate - www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=009402 Depo estradiol/Estradiol cypionate - www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=089310

@heatherhirschMD 3 жыл бұрын

@@boplop5406 I see .. I was referring to pellet injections such is a trigger for me! I just want women to be safe and well informed.

@boplop5406 3 жыл бұрын

Ok. I was referring to injections not pellets. what are your thoughts though on femring and estradiol injections?:)

@janebirkin1000 2 жыл бұрын

I have done Estradiol Valerate shots and didn’t like them. They were compounded in a pharmacy, since factory made Delestrogen and Progynon Depot are it available where I am at, and the quality is very very inconsistent from vial to vial. If you can get factory made ampoules, the shot can be great, as half life of the estradiol esters are about a week give or take depending on how quickly each person metabolizes them. For me they haven’t worked. Very unstable

@deenalynk2534 3 жыл бұрын

Would a low dose aspirin be helpful for decreasing blood clot risk?

@heatherhirschMD 3 жыл бұрын

Many docs have asked this question. Aspirin can also cause a bleeding risk, so at this point we don't routinely recommend baby aspirin with HT, especially if using a patch.