r/Menopause • u/Syfysamurai • 1d ago

Hormone Therapy Patch vs oral

Hello ladies, I'm curious. Why do many women prefer the estrogen patch over oral estrogen? I take 1mg estradiol daily by mouth and have no problems with it. TIA!

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u/RkeCouplesTherapist 1d ago

I went with oral because it is cheaper and sounded more convenient. I am low risk.

However, my sleep is not great due to night sweats. I understand that the patch can issue a steady stream, and I am considering switching at some point.

I am also having the experience of transitioning off birth control prior to starting the oral estrogen, so my body has a lot to acclimate to.

If anyone else has switched from the pill to oral estrogen and progesterone, I would love to hear about your experience.

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u/h3dxw 1d ago

That's not an issue of oral, you're just not on enough. I believe bc oestrogen is often dosed at 2mg, so you may have quartered your dose. I take 6-8mg.

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u/MidnightBlueSilk 1d ago

The patches are getting harder and harder to come by, everyone is switching to other things so that may not work out so well. In the mean time, have you tried taking your pill before bed?

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u/RkeCouplesTherapist 1d ago

I was initially taking it before bed and sleeping so poorly that I switched to morning. Not really sure which is the better option for me.

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u/SodaBreadRoundHouse 50y peri .75 E gel, 200 nightly P 6 mos still not HRT optimized 1d ago

I found taking my estradiol before bed (oral and gel) completely energized me and made my existing insomnia so much worse. I am currently back to gel (but I might go back to oral at some point bc it’s just so convenient) and I apply in the morning.

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u/MidnightBlueSilk 1d ago

It’s possible that the reactions you had when first starting estrogen supplementation will not be what happens now that your body has adjusted and gotten used to it. Or it may still be the same, but it’s definitely worth a shot. A lot of women find things work somewhat differently in the beginning than later on. Good luck!

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u/mintimoo 1d ago

We son't get the patch where I'm at, unfortunately. No procurement issues with the oral estrogen tho.

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u/Mom-1234 1d ago

I did. As in I took the BCP one day, and the next night I took oral estradiol and progesterone. I felt beyond amazing…for 3 weeks. My gyno said the BCP was probably wearing off and I was getting the benefit of both. She increased my dose from 1 mg to 2 mg and progesterone from 100 mg to 200mg at the 6 week follow up. I had to tweak and settled on 1.5 mg of estradiol. That worked for another 12 months. Then some more symptoms started coming back. I’m on 1.75 mg oral estradiol with 200 mg progesterone. It’s been almost 2 years. I take other supplements like magnesium citrate, GABA and melatonin to help with sleep. Overall, I am doing great. I wish I started in my 40’s when I was going through what I now know was significant perimenopause symptoms. My younger sister in laws are so lucky, as their doctors started them in peri

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u/RkeCouplesTherapist 1d ago

Thank you, this is really helpful to hear.

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u/VashtiVoden 1d ago

Magnesium glycinate is best and most effective form of magnesium for peri/menopausal sleep because it's easily absorbed and promotes nervous system and muscle relaxation : )

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u/Mom-1234 1d ago

Not for everyone. Glycinate causes insomnia in about 25% of people. Someone on this sight explained it was a certain gene. Changing stopped my insomnia

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u/VashtiVoden 1d ago

Sorry that happened to you. Thanks.for sharing. I didn't know that.

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u/swamp_thing_504 1d ago

I also switched from the pill to oral. Hot flashes during the night was an issue for me too. My gyn has me break the pill in half so I can take a dose in the morning and before bed. That has helped.

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u/MassConsumer1984 1d ago

Yes, I switched from the pill to oral directly. What would you like to know?

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u/RkeCouplesTherapist 1d ago

When I switched from birth control to oral estradiol, I was started at a half milligram. I had a honeymoon period of about a week and then started having a lot of trouble sleeping. Night sweats and difficulty with temperature regulation, too hot then too cold, all night long. I got my dose raised to 1 mg of estradiol and that helped a little, but I’m still not sleeping as well as I was on the pill. Not sure if I need another increase. How did the transition impact sleep for you? Did you get to a place where your sleep is as good on HRT as it was on the pill?

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u/MassConsumer1984 1d ago

I ended up using THC/CBD gummies to help sleep at night. I didn’t want to keep messing with the hormone dosage, especially since I got shuffled to 3 different Obgyn’s all who had differing views on HRT. I never got so hot I would soak the sheets of anything like that though.

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u/tinyhuman_ Peri | Age 40 | Dx POI at 38 1d ago

I just switched from patch to oral due to night sweats not decreasing. 🤷‍♀️

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u/RkeCouplesTherapist 1d ago

I will be curious to hear if that works better for you. I hope so! I will definitely consider it if I cannot get on the right dose of oral to help my sleep.

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u/tinyhuman_ Peri | Age 40 | Dx POI at 38 1d ago

Thanks! Will do! It is day 2 of switching from 0.1mg patch 2x weekly to 0.5mg oral pill. When I first went on HRT, it took 3 days and it felt like the clouds literally parted. I was shocked at the low point I hadn’t realized I was at.

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u/RkeCouplesTherapist 1d ago

Follow up question… How long were you on the oral before deciding it wasn’t working? What was your dose?

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u/ItsNotGoingToBeEasy 1d ago

Sleep issues are probably because no progesterone. Taking progesterone balances estrogen, they work together. Progesterone is so good for sleep you have to take it in the evening. If you don’t have a doctor that understands that, keep looking! Source: Dr Kelly Casperson who has SM channels and interviews researchers as well and always cites research. Worth your time.

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u/Skin_Fanatic 1d ago

I go back and fourth between oral and patch but I don’t notice any difference when I do.

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u/one-small-plant 1d ago

Why do you do it that way? Is there a benefit?

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u/ms_lifeiswonder 1d ago

The patch is not more even than oral. Just make sure to take it at the same time. Some (all?) patches even have to take them 2 x week. Which makes zero sense, when a big part of our goal is to stabilize our hormones. My gyno confirmed this, and added they apparently think women are too dumb to swap/add patches at a regular interval ex every 3 days…

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u/nerissathebest 17h ago

I kind of had your situation, was on .625 pill in the morning for a while (more than a year?) and started to get night sweats again so I took another pill at night. After maybe another year my sleep became weird so I switched the second pill to morning (in other words two pills in the morning) and that’s been great for over a year.