Hormone Replacement Therapy Patch, Cream or Pill?
Are you looking for the best way to get your hormone therapy medication? This is what this article is about: What is the most effective and
safest way to get your estrogen, progesterone and testosterone into your body.
The way you get the hormones into your body is in many cases more important than what brand or form (synthetic or natural) you are using.
The delivery of the hormone into your body determines how it is metabolized, the side effects, and the risks. So read the rest of the article to find out about the different hormone replacement medication options and what it means for you.
These hormones can be delivered in various ways:
- Orally (Pills and tablets)
- Through the skin (patch, crème, gel)
- Vaginal inserts
- Sublingual (medication given under the tongue)
- Pellets inserted under the skin (testosterone and estrogen)
What is the best delivery form for hormone replacement medication?
There are so many different kinds of hormone replacement medications that we will not provide a list but rather discuss the delivery options. How the medications are taken can be more important than the brand of hormone replacement medication. So which is better, patch, cream or pill? The answer depends on the hormone.
This is what we have found:
- Estrogen should not be taken orally if some of the newer research holds true. Patches, or other transdermal or sublingual applications, are safer.
- Progesterone should either be used as micronized progesterone in pill form, or as natural progesterone cream or gel. Synthetic Progesterone has side effects and may increase the risks.
- Over-the-counter progesterone creams have to contain enough active progesterone to be effective. Wild yam cream does not work because the body can’t convert it to progesterone.
- Testosterone should not be taken orally. Cream or gel is preferred. Pellets and injections are becoming more popular but dosage is an issue.
Check with your doctor for the best option for you. Just make sure that you have a health care provider that specializes in menopause because most general practitioners are not aware of the issues.
Hormone Replacement Medications – Options
There are pro’s and con’s for each method to deliver a hormone into the body and the effectiveness depends on the specific hormone.
Not every hormone can be delivered safely into the bloodstream in the same way. And different delivery methods determine which effects the hormones have.
Although oral medications are the easiest to use, they pass through the digestive tract and the liver. The liver modifies their chemical structure which may or may not cause side effects depending on the hormone.
There is some indication that oral estrogen which is metabolized by the liver, has side effects that can be avoided with other delivery methods. The same is true for testosterone.
Micronized progesterone (the natural form of progesterone) on the other had can safely be taken orally. Actually, taking natural progesterone orally has the benefit that it helps with menopause insomnia. Other forms (i.e. progesterone cream or synthetic oral progestins) do not have this effect.
Hormone Creams or Gels
Hormones that are applied to the skin (often the case with progesterone and testosterone) have to pass through the skin layers to get into the bloodstream and the absorption rate can vary. This means that the actual amount entered into the bloodstream may not be the same with every application or varies between women.
In most cases, these slight variations in the absorption rate may not matter all that much (i.e. estrogen vaginal crème for vaginal dryness) but with some hormones the exact dosage is important (i.e. testosterone cream).
Even the area where a hormone is applied has an effect.
Here are two examples:
- Progesterone applied over tissue that has a fat layer underneath, accumulates in the fat cells.
- Women, who apply testosterone at the same spot over and over, can see hair growth on this part of the body.
Hormone patches, especially estrogen patches are becoming more prevalent because the dose of the hormone is consistent and the patches are convenient to use.
Some women report problems with skin irritations or problems with the residue of the glue that holds the patch in place.
Older forms of the patches had different layers with a gel layer that delivered the medication.
Newer patches are much smaller and have the hormone applied uniformly over a thin plastic film. These newer patches can be cut to adjust the standard dosage. (If you want to use the remaining patch make sure that it is wrapped airtight.)
A newer form of delivery is to insert the hormones in pellet form. As this is done in the doctor’s office, it is more costly than most other methods of getting hormone replacement medication.
Testosterone and estrogen are two of the hormones where this method is becoming popular. Some people report skin irritation or inflammation but others like the ease of use.
A downside of the pellets is that the dosage can’t be changed should side effects occur, until the next implant is scheduled (between 30 – 60 days).
For women who can’t use the standard forms of the hormone replacement medication, the form can be changed by compounding pharmacies (i.e. pill to cream).
Compounding pharmacies also prepare the individualized forms of hormones used by bioidentical hormone doctors.
Most often the bioidenticals are in cream or gel form, but sublingual applications (especially estrogen) are common.
Now that you understand what your options are and their pro’s and con’s, you may want to check out the rest of the articles about hormone therapy.