Vivelle Dot Question

Had my LSH-BSO on Monday the 25th. Have not started any HRT yet. Dr said to use it when I need it. He sent me home with Vivelle .1 dose patches. Beforehand I had insurance check my copays on this in case it is what I end up using.
It was $140 for a 3 month supply. This is a bit steep to me.
Dr. told me to cut my first patch in Quarters and apply only a 1/4 of it at first. If I still have symptoms add another 1/4 etc.

My question is: Do any of you buy the .1 higher dose and cut the patch to the .025 or .050 as your body needs? This would make the patch cheaper and more economical to me. Or is this only the way the Dr. has me trying to find the right dose?

Would the dose be evenly distributed on the patch so that if cut the dosage is still correct?
Tracy

You know its a tricky thing...for many women their stores of estrogen deplete over a period of time...mine took about 3 months...but I could feel it going down bit by bit each month.
I was on the . 075 first, but quickly went up to .1 and I still went down in estrogen.

If I had to do it over I would have had my levels tested right after surgery to know what I had in my system and what to try to shoot for to stay stable...but MANY docs won't do the blood tests.


You can cut the patch...some say it takes away its potency...but I know I have had docs tell me to do it.

I would just really stay in tune with your body...if you feel things changing think ESTROGEN first...that is the lesson I learned the hard way.
Also some absorb the patch well and others don't and have to move on to other forms.

Being so early on you will have to kind of take it as it comes...and stay the course to figure it out.

	Quote:
If I had to do it over I would have had my levels tested right after surgery to know what I had in my system and what to try to shoot for to stay stable.

I've also heard members say they wish they'd been tested pre-surgery to find out their levels and know what to aim for. Unfortunately, for most women, neither idea would have been helpful in the slightest.

First, most of us end up having hysterectomies for reasons that are somehow directly or indirectly connected to hormone imbalance, so the levels we have pre-surgery (or immediately afterwards) are not the healthiest ones for us.

Second, in women with ovaries, hormone levels fluctuate a lot during the course of a cycle, so we'd have to have them tested every couple of days and map out where we wanted to be - a very, very expensive proposition, and I know of no insurance that would cover it.

Third, hormone levels change very rapidly in the early weeks post op -- even those of us who are lucky enough to start out on our idea dose may not feel good during those early weeks, so it would be hard to recognize that we are in fact using the best dose for us at that point.

Also, there is no quantifiable relationship between hrt doses and how that's reflected in serum hormone levels. It's different for every HRT and for every individual depending on lots of variables, including (but not limited to) weight, activity level, stress level, and characteristics of the skin or GI system, depending on type of HRT used. So, even if we did know what an ideal level was for us (and it differs for everyone), we would have no clue how to adjust our HRT to get there, and frankly, medical professionals who tell you they can choose your ideal HRTs based just on one test, whether blood or saliva, are feeding you a line, because no one can do that with the state of knowledge we have today.

(((auntshamaine))) It is OK to cut estrogen patches if they are of the "matrix" type and not the "reservoir" type. The Vivelle-dot is a matrix patch. The hormone is evenly distributed over the patch so, if you are accurate in your cutting, it is possible to, say, halve the dose by cutting a patch in half. However, it's not usual for a doctor have you cut one in quarters - there is too much margin for error there. I would not suggest it as a long term solution.

Is your copay lower for lower dose patches, should you end up finding out that's what you need? For what it's worth, the amount you were quoted is less per month than what I pay for my Vivelle-dot 0.1mg/day patches. I also pay well above that in addition for vitamins and supplements that I need to feel well. Unfortunately, surgical menopause is very expensive, and that's not something we are usually told ahead of time, mostly because surgeons aren't aware of the little practicalities like this.

Good luck with your patches!

s,
-Linda

surferbabe- thank you so much for a very informative response. I found it very helpful. I do believe he meant this to be a short term idea as we determine what works. If it works I may possibly consider cutting them in half. I did not check the copays on all doses, so,yes it could be less I guess. Also, hubby just brought home paper work for new insurance! So now, that copay won't be right!! LOL So now it is back to the beginning any way. Thanks again for the response.
Tracy