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Vivelle Dot: Start up 'issues' & expectations Vivelle Dot: Start up 'issues' & expectations

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Unread 06-04-2010, 07:53 AM
Vivelle Dot: Start up 'issues' & expectations

Hi all,

I am 41, 4.5 weeks out of a total hysterectomy due to a large mass that had 'eaten' my ovaries. Good news is that all surrounding tissues were benign, and the mass only had one spot of atypia (talk about early intervention). And I'm healing well.

Bad news was at 1.5 weeks, menopause set it with a flashes (every 45 minutes), night sweats, insomnia (sometimes as little as 2 hours a night), fuzzy brain, migraines, weepiness, no energy...the works. I attributed it to no hormones, but it was all the more disconcerting as prior to the surgery, I was healthy as a horse, very active, and almost never had period-related symptoms.

Finally, was able to get the okay from my gyn/oncl, and found a ob/gyn who felt comfortable giving HRT to someone in my shoes (both my PC MD and their ob/gyn were uncomfortable giving HRT due to my atypia). To begin, my doc put me on .05 Vivelle dot (I am very, very sensitive to medication) and said, get back to me in a month if the issues don't disappear.

So, yesterday afternoon, I got home and slapped the thing on my lower right abdomen (I was surprised how tiny & unobtrusive the patch seemed). So, for those of you on Vivelle dot, I have some questions:

1) It was weird, I felt a little 'surge' within an hour of putting it someone turned up the energy thermostat. Is this normal?
2) I still woke up with hot flashes, but felt more rested this morning. Normal? No headache today (yeah!)
3) How long, in your experience, did it take for the hot flashes to subside?
4) The spot around the patch is I did too many situps. Is this normal? I'm not crazy about this, particularly since it's right where the ovaries would have been (and I've been having surgical recovery pain at that spot). Anyone have less soreness moving it to their backside?
5) If I move the patch to my posterior, does it go below the hip bone (upper butt), or on the curve of your butt (i.e. the fleshiest part)?

Thanks in advance....

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Unread 06-04-2010, 11:14 AM
Re: Vivelle Dot: Start up 'issues' & expectations

Navi-Jen, I am also on the Vivelle dot .05. I was given it the day after the hysterectomy by my GYN. He said to check back at my appointment in mid-July and let him know if we need to make adjustments. I had a lot of hot flashes in the last few years (I'm 46 now) but a changed in birth control pills helped with that. Right now I am only 14 days post-op and can't really tell how the Vivelle dot is helping or not helping. I do have some hot flashes but they could just be from exerting myself too much. I really have felt great after the surgery; don't even take OTC painmeds. I just have very little energy (also could be attributed to surgery). My GYN said to change the dot every Thursday and Sunday and to rotate left and right side of the lower abdomen. He said I could also put it on the back but I am worried it could come off in the shower or while getting dressed. If your skin does not tolerate the patch, do let your doctor know. I do have discomfort in the lower abdomen but none at the incision sites for the daVinci procedure. I think I am doing a little too much; it does feel like I have done too many sit ups (but less than menstrual pain). Not much help from me but let me know how it goes.
Unread 06-04-2010, 12:45 PM
Re: Vivelle Dot: Start up 'issues' & expectations

Hi Navi_Jen I'm glad you were able to find a DR who supported your desire to try HRT. I know how hard it is when you have an "atypical" history.

I've been on the Vivelle-dot for over eight years now. I'll try to answer your questions from my experience:

1) Many women feel a 'surge' when they first start HRT or raise their dosage or change HRTs... it's normal. The symptoms are due to the sudden hormone change.

2) It sounds like the estrogen is starting to work. Hard to say after only one day whether this is the right dose for you or not. When you're balanced, you should not have any hot flashes. You should feel just like "you". You should, basically, feel nothing, at least that's how I describe it. But one day is waaaaay too little time to tell - as your DR indicated, it takes a long time to see if it'll work well for you. Four to six weeks is ideal. If you get impatient and make changes (like increasing the dose) sooner, you will never know if that dose would have worked if you'd left it long enough.

3) For me, the hot flashes subsided immediately, but I am on a higher dose than you and was perimenopausal pre-surgery, so I did not have stored estrogen - ie, I started having a hot flash in the recovery room. I was lucky in a way, in that the dose my DR prescribed initially is the one that works for me, but I went through several months of adjustments and trials which were quite miserable before returning to it.

4) I have not had soreness around where I put my patches, but I put them on my backside and started doing that almost from the beginning. I found that they stick better there and tend to wrinkle much less, if at all. After several months I did get an itchy rash where I removed patches, but was able to figure out how to make that go away. Still, that wasn't "soreness".

5) If you decide to move the patch to your backside, move it there and keep it there. Don't alternate front to back. The absorption is roughly 20% higher in back so you will be getting more like .06mg/day instead of .05. If you alternate front to back, the ups and downs will cause hot flashes. I wear mine in the area where the jeans pockets cover, and also to the outside on the hip area. Just make sure your panties' or pants' waistband or leg bands don't rub against it because that can cause it to come off if it starts sticking to your clothing.

You may find it helpful to keep a journal of your symptoms, particularly if you end up either adjusting the dose or adding another hormone to the mix. Also, be aware that as you ramp up your exercise program, you will need more estrogen, so if the dose works perfectly during your recovery don't be surprised if you start having hot flashes if you start exercising hard.

I hope this helps.

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Unread 06-04-2010, 03:10 PM
Re: Vivelle Dot: Start up 'issues' & expectations

Its been 6months since my surgery, no ovaries, or hormones, i have been living in hell, that is the best way to say it, the hot flashes take my breath away, i'm tired out and hate waking up in the am, had gotten a message from someone here that made me feel like i was the biggest whinner in town, told me that i should suck it up, well i'm done with that and i'm going to see a obgyn for a patch anything that will help as i have tired to suck it up and its not working. Thanks for posting inf on the patch,
Unread 06-05-2010, 10:48 AM
Re: Vivelle Dot: Start up 'issues' & expectations

Thanks all....

Coraprof...Like you, I was off pain meds quickly (within a week of surgery) but the tiredness was overwhelming. I definitely think the bulk of this is due to the surgery...I've experienced this with 2 other major surgeries I've had (knee & ankle), as your body is sending its energy to the surgical site (for repairs) and doesn't have a lot left over.

Also, morphine/codeine based pain meds have a long half life, and can take up to 6 months to be fully expelled by the body. So the tiredness is not surprising...My energy started to come back in week 3, before it was robbed by my insomnia/hot flashes. Are you sleeping through the night? This, along with gradual increase in activity (10 minutes walking, then 15, etc) should help with the tiredness (at least it did from my previous surgeries). Also, week 4 is when my internal abdomen really started to feel less painful. Are you also 'working' on your scars, to rub out the adhesions? These little lumps can impact pain/nerve endings throughout the abdomen, so I'd suggest gently rubbing them several times a day (rub at a 90 degree angle to the incision line, with a little vitamin E or Aquaphor for lubrication).

Linda-thanks for the comments on the dot. It really does seem to be working...My energy level & mood have elevated 95%. Really surprising. The achiness on the site has subsided, don't know if that's because its been 2 days since physical therapy, or the rush of hormones has subsided. Guess we'll find out when I move the dot to my butt on Monday. Good recommendation, too, about the exercise. I forgot that strong exercise decreases estrogen...guess I'll have to monitor it, sorta like how diabetics have to monitor their blood sugar. It's just a hard transition, as I've never really had to monitor my health up 'til now. *Sigh* guess its just a factor of getting older.

Bess-I totally understand what you are going thru. I wanted to try to tough it out, and I have a pretty high pain/uncomfortable tolerance...but the swift (and fierce) change was too much to take, particularly since there are relatively low risk solutions. I read up on the Vivelle, and liked it due to its bio-identical properties, and its bypassing of the intestinal tract/liver. And I HATE to take anything, even aspirin...but the menopausal side effects were too debilitating not to try to address.

Once I put the patch on, I felt it working within hours. The overwhelming sense of tiredness, the bad headaches, the depression, started to lift within hours. And I am sleeping better, although I still have an occasional, but much less severe, hot flash. Personally, I asked to be put on a smaller dosage, and be willing to wait to see if my hormone levels balance out, rather than potential overkill.

If you can, I might suggest reading up prior to your doctors visit. Particularly since the big NIH study is just wrapping up, there is alot of information (some targeted to specific audiences, some not). 'The Cleveland Clinic Guide to Menopause', 'Natural Hormone Balance' (author Uzzi Reiss) and 'What your Doctor Won't tell you about Menopause (Author Dr Lee) all have some good information.

Good luck, and thanks for the info....

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