I feel like they'd be more convenient for me because I am so forgetful that it's now been over a month since I've taken my HRT, and my prescription lapsed with 5 months worth of refills remaining.
What should I be aware of, other than the cost difference?
Theyre the best hrt option if you can't tolerate needles in the long term, get dressings so you can prevent them coming off, be super careful in the shower (i honestly avoid that patch of skin and then wash it once I'm out of the shower very carefully)
never done hrt patches but from my experience quitting smoking patches are itchy and can be kind of inconvenient if you move around a lot/are somewhere hot
For E patches, you're supposed to stick them somewhere where the skin doesn't move around a lot, e.g., upper butt cheek area. They still get itchy if you sweat a lot, though.
Doctors have no clue how to dose them. I was with a doctor who 'specializes' in lgbt care but was on patches for almost a year and did near nothing. Injections are how I got the body I have today.
They fall off at the slightest provocation. Sweat, showering, bathing... You're lucky if the damn thing stays on afterwards.
If you slap a couple of 3M Tegaderm dressings over it (minimum of two of the 2 3/8" x 2 3/4" ones, P/N 1624W, available in bulk via Amazon), it will stay put, but the Tegaderm dressings may start to roll up around the edges a bit. Once they start getting lint in them, it's a race until you're due for your next patch to see if everything stays in place until then.
You also can't do monotherapy with the Climara patches; the dose isn't high enough, even with the 25 cm2/7.6 mg ones. Bica works pretty well with them.
Skin irritation is also a possible concern.
Edit: My regimen for getting the best patch+dressing adhesion is as follows:
- Shower and shave the area about an hour beforehand. Rinse extremely well; any lotions, oils, or sweat will stop both the patch and the dressings from sticking.
- When you're ready to apply the patch and dressings, put an ice pack (or very cold, wet washcloth) over the area where you're going to put the patch. Keep it there for a minute or so, and blot dry afterwards.
- Use an alcohol prep pad on the area before applying the patch and dressings to get any other residual oils out. Waft it dry.
- If you're feeling froggy, you can stick the patch in the middle of a Tegaderm dressing before you put it on. If you go this route, you'll need three dressings total to ensure enough edge overlap on the sides.
- Otherwise, you can get away with two dressings, with the edges overlapping over the patch.
I'm probably doing it wrong.
Also, they're more effective than oral estradiol on account of the estradiol not getting metabolized in your liver. But it suuuuucks when you ruin a 1-week patch on day 3 and have to slap on the next week's. Keep gel as a backup -- the homebrew stuff from Otokonoko is supposed to be really good and fast-drying, but I haven't tried it yet.
Sometimes they feel itchy. Some people get a reaction to the adhesive. I found it was better for me than taking all the oral estradiol twice a day. Apparently, they're associated with lower risk of estradiol complications (like clots etc) but the research I saw chalked that up to lower and more stable doses, I dunno. It's probably not worth switching JUST for that.
Oral estradiol does have a risk of clots and liver damage. It's not as bad as synthetic estrogens, but it's still there because all estrogens are subject to a strong first pass metabolism with lots of thrombogenic metabolites, meaning that most of the stuff gets broken down into clot-causing stuff when you take it orally and it has to pass through the liver first before it enters your bloodstream.
You simply don't have any of that with patches, gels or injections.
Also, from what I've read it only increases your risk to normal cis female level lol
I actually doubt it's even that. The increased clot risk in cis women is mostly due to some contraceptives - these are usually snythetic estrogens taken orally. Apart from that, AFAB individuals are only at a higher risk of thrombosis when they're in the phase of the cycle where estradiol and progesteron take a sudden nosedive - that's something that just doesn't apply the same way in a trans woman on HRT, which normally means much more even hormonal levels.
I don't need estrogen but I need the rest of that bit
