#estradiol patch

[regalvoid]

I wish my insurance covered the good stuff

[mental-mona]

Estradiol patch dose too low? Signs HRT isn’t working

If you suspect your estradiol patch dosage is too low, talk to your doctor. You may need a different dosage or type of estradiol patch. Here

[hormonepuzzle]

Sometimes the Problem Isn't the Patch

The word has been trickling out to psychiatrists that they can often boost the effectiveness of psychiatric medication for their female patients if they also prescribe an estradiol patch. Women over 35, women who have problems with their ovaries, post-menopausal women and post-partum women may be particularly vulnerable to mental problems due to lack of estradiol in the body. Estradiol plays a vital role in the performance and maintenance of the female brain, which is probably why mental illnesses are statistically more common in women at the times in life when there has been a "hormone event".

"Hormone event" sounds like a lot more fun than it really is. It means a time when there is a large hormone change, like puberty, menopause, and after giving birth. If a woman already has a mental illness, this kind of "event" can send her off kilter and into a locked ward. It may seem as if the medication no longer works, or that the disease has entered a more severe stage. Often, the psychiatrist will increase the medication, which increases the risk of serious side effects. Little known pharmacology fact-if you give a patient too much psychiatric medication, you can actually induce the symptoms you meant to cure. So if your loved one seems to be getting worse after his or her dose of medication is increased, consider this possibility.

So if you are lucky and see a psychiatrist who recognizes the problem, checks your hormones, and prescribes an estradiol patch to boost the effectiveness of your psychiatric medication, your problems are over, right? Well......

I swear this happened to a friend. She was working in a public school when a mother of one of the children came into her office and began to rant about her psychiatrist and how the patch he gave her didn't do a damn thing. Aware that this woman was schizophrenic, my friend sat quietly and hoped she would talk herself out. Suddenly, the woman pulled down her pants, bared her hip and dramatically pointed to the estradiol patch, screaming, "it doesn't do a damn thing, and it won't stay on!"

My friend looked at the patch, which was held on with band-aids, and asked her if she had peeled off the backing on the patch.

"What backing?"

Problem solved. After explaining that the plastic patch backing had to be peeled off, and then applied to clean, dry skin, and then pressed on with the hand for thirty seconds or so, the woman ripped off the band aids and applied it correctly. 

By the following week the scenes had stopped, and the woman's behavior greatly improved for the rest of the school year.

So I just want to suggest that any psychiatrist who prescribes an estradiol patch should demonstrate application techniques to the patient, or to whomever handles the patient's medication. 

Probably a good idea to demonstrate how to apply the estradiol gel, too, just to be safe.

[hormonepuzzle]

Got a phone call yesterday from a friend worried about her mother, who is in the hospital. This 82 year old lady has multiple health issues, among them an enlarged heart and cardiac arrhythmia problems. In simple terms, her heart has had to work too hard and gotten too big, and the electrical signals that should make her heart beat normally are not firing properly. It's a lot like having an electricity problem at home, where the lights keep flickering on and off instead of staying steady. Usually, the doctors will operate and put in a small machine that will ensure that the heart electrical system works correctly, but this woman, Madam X, might not survive such an operation. Many other medications that might help her had to be ruled out because of her kidney problems.

Her doctor, being a very smart cardiologist indeed, knew that there was a simple, non-invasive treatment that would improve her heart rhythms, relax the veins and arteries to take the pressure off of her heart, and would improve the muscle function of the heart. This medication is the same stuff that her body made when it was younger, so it won't cause any liver or kidney problems, and is relatively inexpensive. I'll even give you a really big clue-it will help improve her bladder control and incontinence problems. Give up?

Estradiol. The primary female hormone made by the ovaries before menopause.

Madame X uses an estradiol patch on her arm twice a week, and has not had cardiac arrhythmia problems since she started using it. At 82 years of age, this is not about hormone replacement therapy, but about finding the best treatment for her personal health problems. During the recent health crisis, the hospital removed her from all medications while it tried to figure out the source of her kidney problems-this is standard protocol with sound science to back it up. However, the loss of her estradiol patch nearly killed her as her blood pressure dropped and she developed heart arrythmias. After intervention from her cardiologist, her estradiol patch was replaced, and within hours her heart rhythm settled back down again. From a humane point of view, this was much less scary for an elderly, confused woman than a bunch of heart machines. From a cost point of view, this was thousands of dollars cheaper. She's feeling a lot better today. They will send her, with her estradiol patches, to a rehab facility in a day or two.

Want to read the research? Here's a list of selected research citations about cardiac arrhythmiasfrom the government research database, PubMed:

http://www.ncbi.nlm.nih.gov/pubmed?Db=pubmed&DbFrom=pubmed&Cmd=Link&LinkName=pubmed_pubmed&IdsFromResult=20004189

Selected research about the effects of estradiol on the urinary tract is here:

http://www.ncbi.nlm.nih.gov/pubmed?Db=pubmed&DbFrom=pubmed&Cmd=Link&LinkName=pubmed_pubmed&IdsFromResu

Dr. Elizabeth Lee Vliet, who specializes in women's health, has some similar stories in her books, Screaming To Be Heard, and It's My Ovaries, Stupid. Those stories, about young women with cardiac problems, deserve a separate post, though.