I have been on the combipatch for 11 years. I am 62 now. Before starting the patch I tried over the counter herbal supplements for a couple of months and nothing was improving my hot flashes that came with anxiety. I was on the highest dose 50/250. I have never taken any prescription medicines my whole life except this Combipatch. I exercise a lot going to the gym 3 times a week and walk my dog 4 miles a day. I use to go to a workout trainer who had me in my best shape ever 2 years ago to compete with college kids in a boot camp for an hour up and down a hill. They all thought I was Supermom. My normal resting heart beat is 50 bpm. I have had blood work done..the last one was this past February (2018) and the results were excellent for someone my age. About 3 months ago I decided to get off the patch to see if I still get the flashes with anxiety and because I was getting some heart palpitations (going up the stairs, washing my hair in the shower, just getting out of bed in the morning) my heart would go from 50 bpm to 100 bpm and last for about 3 minutes before dropping. In 5 days the hot flashes came back slowly and after 2 weeks the flashes and anxiety were the same as when I was 51. Two months later of hot flashes, anxiety and palpitations, I contacted my OBGYN to see what he would say and he suggested I go on Lexapro (Escitalopram) for the flashes and I was confused becuase this prescription medicine is for depression and anxiety, but after doing more research it is also used for hot flashes. I was not depressed but hot flashes brought on the anxiety and yes, made me feel depressed that I had to deal with this again! I do NOT sweat, just fell the aeora of my body on fire. This is what my OBGYN commented in our online discussion: “Hot flashes and night sweats are called in the medical literature vasomotor symptoms. I have taken liberty of comp being information from Escitalopram which I have inserted below. Vasomotor symptoms associated with menopause (off-label use): Oral: Initial: 10 mg once daily, increase to 20 mg once daily after 4 weeks if symptoms not adequately controlled (Carpenter 2012; Freeman 2011; NAMS 2015). This could certainly be utilized and also tends to be taken at night for the greatest effect on the night sweats. Yes it is also use for depression but vasomotor symptoms (hot flashes and night sweats) are caused by brain neurotransmitters being an abnormal levels which is also 1 of the problems with depression. So the medication can treat both situations but in your situation we would be primarily using it for vasomotor symptoms.” So, after doing some more reading up on Lexapro I decided to NOT take this because of what was said about the side effects. These medicines just scare me. I am now BACK ON THE COMBIPATCH (2 Patches taken so far). I expect it to kick in very soon here because when I started the patch at 51 within the 3rd patch I was pretty much clear of hot flashes/anxiety. It worked very well and very fast with me with no bleeding, no patch residue of itching, nothing. My mom still gets hot flashes at 86 (told my husband to kill me in my sleep when she told me this). I have realized that I might be on this patch until the day I die. I did mention to my doctor about using only half the patch and he said, “The patch should not be cut in half because that interferes with adhesiveness and absorption of the med. It is a low dose of estrogen and I think you should do fine with the full dose.” I have already seen a Cardiologist about my palpitations and she had me on a heart monitor for 2 weeks. Next step is an Echocardiogram on July 11th and then I should have some answers. I believe it to be nothing but stress related but I am not the doctor. I had not exercised at the gym for these past 3 months (stopped because of burn out and to take a break) only walking my dog. Last Friday (6/29/18) for the first time, I went to the gym for an hour which I do this boot camp myself and then again yesterday. Strangely, my palpitations are gone and I realized the palpitations started after I stopped exercising. What the heck! So here I am back on the combipatch and I once again I know I will have my life back with a good nights sleep. I will take my chances with developing any of the bad stuff I read about taking this patch because I can NOT live with no sleep (hot flashes 5 times a night) day flashes (8 a day) and the anxiety that comes with them....no life at all..just miserable. It messes up our minds! My best to all who have to deal with these female problems. My next life I hope to come back as a dog to an amazing person who takes me everywhere, feeds me the best nutritional food, trains me to be the smartest and gives me the unconditional love that I give them 24/7.

Hello Pastapup or anyone...! I note pp that you seem to be educated on the above bhrt and was wondering if this is what you take? I'm considering starting Vivelle Dot and Prometrium cyclically (i've been researching for awhile).. I'm 4 years post meno and early at that.. having my last period at age 44 now 48.. toughed out all the usual suspect symtoms but now 3-4 years into post meno... I've started bad v atrophy, bone loss, bladder issues, libido loss, brain fog..etc. I was just hoping to get some insigh into dosage and maybe what to expect in the first few months.. I have a gyni who is pretty good but she is not a supporter of cyclic method... (getting a period) and yet alot of what I have researched said this is the best way.. Anyway, I noticed your post was this year and thought you might still be around.. as many of the posts I have read are much older... thankyou.

I started doing gymnastics with my daughter, (adult classes) a week ago. My back aches and aches and so do my feet after standing up for an hour and for my work which requires several hours of standing I am nearly crippled! (I am on the estradot patch at the 25mcg (smallest dose) after getting my estrogen, progesterone and other hormones checked this was the best dose to give me adequate estrogen as the higher strengths had my estrogen too high. My progesterone is very very low.) I have been O.K with sleeping until this excersize started and now am finding I am waking up too early and suffering alot of restless leg syndrome. I wont be able to do this if this keeps happening! Does anyone know why excersizing would throw my hormones so out of wack and has this happened tgo anyone else. By the way I am not skinny and have a solid appearance so I doubt it is caused by weight loss.

Expanding on what others have said, the estrogen creams and gels for skin, as opposed to vaginal, use are prescription forms, made up by a compounding pharmacist to a prescription written by your own doctor (the pharmacist can help him with that if he is unfamiliar with how to write this kind of prescription). There are compounding pharmacists in Canada and they can make up these forms of HRT, but they are somewhat harder to locate (less common) than in the US. The main difference between using a topical cream/gel and using a patch is that the patch gives a steady release over the life of the patch (more or less) where the topicals give more of a curved effect, peaking after the dose and then dropping off till the next dose. Whether or not that makes a difference to any particular woman seems to be an individual thing: some dose with topicals once or twice a day and do fine; others have to go to multiple doses to avoid too much variation in hormone levels. The vehicle (there are a number of different cream bases, not to mention the gel) and where you put it (fatty tissue versus not) also affect the length and shape of the absorption/circulation curve. So, as with everything else menopausal, there's a lot of personal variation and you may have to experiment some to find the best one for your own body. There are, as Leigh notes, no effective over the counter variations on estrogen creams and gels.