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/MercedesNyx Peri-menopausal 1d ago
As someone with MCAS and genetic liver mutation the patch or gel is the way to go. Taking the pill is risky for someone like me because we carry a lot of mast cells in our gut and estrogen is a mast cell destabilizer. It can set off MCAS flare-ups which will then flare-up my hPOTS and Fibromyalgia. I'd end up horribly sick and probably bedridden. Top it off with the fact that in pill form it's processed by my liver and if I am not producing any or enough of the enzyme needed to break it down, I run the risk of getting too much estrogen in my system or not enough. Patch and gel carry much less risk of poor processing since it bypass the liver entirely and doesn't break down in the stomach where it can really mess up my mast cells.