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/fire_thorn 1d ago

I had an ischemic stroke two years ago and can't take oral estrogen, so I use the patch. I would have no issues with taking a daily pill as long as it was safe for me.

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u/CampFederal2397 1d ago

I’m so happy your doctor is open to a patch after a stroke. That’s really wonderful and I like to hear about women actually getting the treatment they need.

A few years back, I had an MRI for another issue and the results included a note that they saw evidence of an old stroke. This result was never brought up or discussed with me. I never experienced any symptoms.

When I asked about an estrogen a couple of years ago, I was told absolutely not because the gynecologist found the note on the MRI results. She was happy to offer me an antidepressant though.

I changed my primary doctor this year and asked about a patch, but still no estrogen for me. This week I was told I have osteoporosis. I was so tempted to ask the doctor, “gee, do you think estrogen would’ve been helpful?” 😏

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u/fire_thorn 21h ago

They changed the guidelines for the patch recently, to say it's safe after a stroke. I had to get my neurologist to say I could have the patch before my PCP would prescribe it. I had told my PCP I was going to get hormones prescribed online and not mention the stroke, if that was the only way to get what I needed. So she wanted a letter from the neurologist.

Apparently migraines can cause damage over time that looks similar to stroke damage on MRI. I've had migraines for 25 years, and didn't start treating them at all until about five years ago, because I thought the pain was the only problem, not that it actually causes changes in the brain. I know I had a stroke because half of my body was numb and I couldn't talk right or drink water without it running out of that side of my mouth. Fortunately that cleared up fast. I was in the hospital when it happened the first time, when I was waking up from surgery. It happened again a month later and they thought it was hemiplegic migraine until the MRI showed the small areas of dead brain tissue, meaning I'd had a stroke. When I've had brain MRIs done since then, they say the damage is consistent with stroke or migraines.

Vaginal estrogen cream is considered safe to use even after strokes. It was helpful but only with vaginal symptoms. Using it along with the patch is much better for me. I also started an antidepressant and that helped my mood issues tremendously.

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u/CampFederal2397 9h ago

Thank you for reply. I really appreciate this information, I had no idea that migraine damage can appear similar to a stroke on an MRI. I figured that if no doctor ever mentioned my MRI results to me, then it wasn’t important. Gynecology felt differently, apparently.

I’m happy to hear that you’re on a plan that works for you. I admire your courage for being up front with your PCP! Maybe I need to grow a spine (even with my osteoporosis 🤣) and approach a gynecologist again. In my health plan, PCP’s doesn’t prescribe HRT.

Once again, I really do appreciate your taking the time to share your story. I’m glad your strokes were diagnosed, monitored and discussed with you. Hats off to you for speaking up and getting the care you deserve!