After 14 months, I think I'm going to try Vivelle...

....and I'm a little nervous! Right now I'm using .81 (I know, that .01 is so random) of Biest 50/50 and all in all, I feel...ok. Still have some hot flashes, still have difficulty focusing and concentrating. My hormone doctor says I'm taking a large dose and although my saliva testing came back within the normal range (though I'll admit, the high side of normal), she doesn't want to increase my dose and in fact, would prefer I lower it. NOT A CHANCE. I felt terrible, like I was walking in a nightmare at lower doses.

Anyway...

My surgeon (and GYN) thinks I should be on the patch, she believes that compounded is sometimes just not potent enough for some woman (plus she just DOESN'T prescribe compounded hormones). So I'm thinking about changing. Has anyone ever done this? What was your experience? What do you think of the patch? And, since I take .4mg of estradiol in my cream per day, what dose do you think I should be on the patch?

I did a stint with the compounded creams and didn't have very much success. My 24 hour urine and the saliva tests always showed that I was too high, yet my serum estradiol level was 11 or 12. I didn't absorb the hormones in the cream base well at all. I did switch to the patch. I had some issues with it sticking, but have worked out that bug I think. I also liked the fact that I wasn't going to have to be concerned with transferring any of the hormones from my skin to any other family members or my very affectionate dog! My insurance was much kinder with payment on the patch vs. almost no reimbursement with compounded. The bottom line is also that it doesn't much matter what a lab test reveals if you don't feel well. It makes you feel crazy when the tests and the Dr. are both saying that you SHOULD feel fine and you don't!

Do you mind me asking what patch you use? Do you feel good?

I use Vivelle Dot .1 strength (the highest dose). I also have the added issue of hypothyroidism to complicate things a bit (one med effects the other). I've recently changed thyroid medication and it's dropped my estradiol level enough that I supplement with a bit of added estrogen. I do use 1/4 mg compounded troche that I use transbuccally. In addition, I can use a small portion a couple of times a week for vagiinal issues. I have my troches made with no flavoring.

I'm feeling much better now. I've had several years with trying almost everything under the sun. I'd used oral Estrace for many years and wanted to stop swallowing the whole dose. No matter what I tried I always seem to come back to Vivelle Dot. It's small, I like the 2x a week changing schedule, and I need that constant trickle of estrogen to feel more normal.

E2Me2 - how does thyroid medication affect estrogen levels? Ther reason I'm asking is 60 days prior to my surgery my Thyroid medication dosage was increased (levoxyl). Then it was increased again about 2 weeks after my surgery. In between the two dosage increases, I had my last remaining ovary removed and put on an .1mg estrodoil patch. At four weeks I'm feeling great on the patch and the new thyroid medicine (on the other hand, I haven't been doing much but lying around the house) but I've read other comments about thyroid meds and estrogen interactions. I've been hypo for about 10 years. Just wondering for future reference.

E2Me2-I also have hypothroidism. My estrogen is super low and I suspect my thyroid levels are off as well. Can you tell me how you got both levels sorted out? I am on .0375 vdot right now trying to get my estrogen levels up. I don't think I want to mess with the thyroid until we have the estrogen straightened out. I don't want to change too many things at once.

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Originally Posted by Debbie0613 E2Me2 - how does thyroid medication affect estrogen levels? Ther reason I'm asking is 60 days prior to my surgery my Thyroid medication dosage was increased (levoxyl). Then it was increased again about 2 weeks after my surgery. In between the two dosage increases, I had my last remaining ovary removed and put on an .1mg estrodoil patch. At four weeks I'm feeling great on the patch and the new thyroid medicine (on the other hand, I haven't been doing much but lying around the house) but I've read other comments about thyroid meds and estrogen interactions. I've been hypo for about 10 years. Just wondering for future reference.

I just recently had the increase (and recent switch to Armour) in my thyroid meds. I noticed within about a week or two that my low estrogen symptoms were coming back. With each tweak, I've had to up estrogen dose. I'm guessing that while in the hypothyroid state that the metabolism is slowed quite a bit. That has included the processing of foods as well as my meds. I would think when things are revved up to a normal level the estrogen is cleared much more quickly.

When using estrogen, it can raise the binding globulins that keep the hormones from reaching their targeted tissues. I think the oral estrogens seem to have a higher impact on that than the transdermal methods do.

The advice on here has been to get the thyroid levels good then to work on the estradiol. It seems that when one gets tweaked it's always good to check the other shortly after.

I'm glad you're feeling good now! When you get really active it can sometimes change how quickly the estrogen is processed too. Just be mindful of any new symptoms when changing activity levels and you'll be fine!

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Originally Posted by wildcatchick E2Me2-I also have hypothroidism. My estrogen is super low and I suspect my thyroid levels are off as well. Can you tell me how you got both levels sorted out? I am on .0375 vdot right now trying to get my estrogen levels up. I don't think I want to mess with the thyroid until we have the estrogen straightened out. I don't want to change too many things at once.

Actually, the advice on here to get thyroid levels right first is what really helped me. I kept getting symptoms of too much estrogen even while using a low dose. It's like my body was craving it and yet not handling it at the same time. If you suspect your thyroid is off, can you ask your Dr. to recheck your levels for you? Does your Dr. check Free T3 and Free T4 as well as the TSH? If you know that your thyroid is ok you could then focus on your estrogen levels.

Thanks for the information, E2Me2. That's helpful to know. Feeling good now but as you pointed out things may change when my activity level increases. Fortunately, my Gyn is helping me with my thyroid right now (my family doc refused to change my meds, saying I am within normal range). The reason I ended up at the Gyn to begin with is my hair started falling out in clumps last summer and I thought it might be hormones (my family doctor blew me off). Her first response was 'no, that sounds like thyroid. She looked at my 'normal TSH' and said for someone with known hypothyroidism it was too high and adjusted my meds. At my prep-op she rechecked my TSH and it hadn't budged, so she upped it again. If this doesn't do the trick I'm going to ask for an endocrinology referral. The problem is, as you are probably aware, not every doctor is willing to fine-tune the thyroid meds if you are 'within normal range'. It can be difficult to find someone who subscribes to thinking outside the box. The good news is there is a reproductive endocrinologist within her practice so maybe he would be more in tune with the thyroid-estrogen balance issue.

You can go to Vivelle website and download a coupon for a free month supply of the Vivelle patch. Today, I gave it to my pharmacist and they accepted it. I change my patch twice per week. I think that I need to up the dosage. However, my dr wants to check my blood levels first. Will get blood work done this week. My patch stays on until I take it off. I like that.