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Cindy,
Some people are really sensitive to the peaks and valleys of the patch. I had that problem myself and had to wear 3 or 4 low dose patches and just change the oldest one each day. That did the trick for me. I also used progesterone cream which is would suggest that everyone on estrogen check into using. I do not think adding progesterone would help the estrogen level fluctuations, although some people are able to lower there estrogen dose while on progesterone. Talk w/ your doctor about it

Cindy,
A compounding pharmacist can mix you up creams of both estrogen and progesterone. I did better on the estrogen patch but did ok with the progesterone cream. Everyone is different but w/ me the estrogen was absorbed really fast with the cream and then I was on a downhill the rest of the day. Some people really like it though, so hang in there and try the different options.

Another choice is something called a troche. That is something that the compounding pharmacy can make up that disolves under your tongue. This absorbes in a similar way as the creams would through your skin bypassing the digestive system.

Taking a pill is an option but keep in mind that when you have to swallow your hormones you have to take 10x the dose as a patch or cream to get the same blood level of the hormone. That means your poor liver has to rid your body of that other 90%. There are studies now showing that the transdermal estrogens are not as hard on your body as the swallowable estrogen pills...bioidentical or not.

When you see the compounding pharmacist make sure that you get set up with seperate estrogen and progesterone until you get your doses straight. As you become familiar with the symptoms etc you may find that you need more progesterone on certain days depending on stress levels etc. So even though it seems easier to combine the two hormones it is best to keep them seperate at least until you are sure that you are on the right dose and that dose is constant. Before you go to the compounding pharmacist you shoulld have your testosterone levels checked to see if they are ok or low. A few women need testosterone too.

One other thing to mention.....it is not a bad idea to test the thyroid because all the hormones work together. Good balance means all the hormones are at optimal levels. Some doctors will test cortisol which is an adrenal hormone. Each time my doctor checked my hormones she checked
Estradiol
Estriol
Estrone
Progesterone
Testosterone
Thyroid
Cortisol

Let me know if you need any more info

I will be thinking of you.

sorry you are having a rough time. Please go to www.hysterhealth.com for support and help with your situation