Disadvantages include skin reactions in some women, the cost (double that of pills), and the need to remember to change patches twice weekly. Skin irritation, which some studies indicate is a problem in up to 40 per cent of users, may be overcome by regularly changing the position of the patch on your body. Another thing to remember is that the site of the patch may affect the rate of hormone absorption into your system. For example, if you place a patch on a part of your body that is moved frequently (such as the upper arm), your body will absorb it faster than if the patch is attached to your abdomen.
Sydney neurologists have described the case of a woman attending aerobics classes who experienced mysterious throbbing headaches, nausea and intermittent dizziness that were eventually traced to her hormone patches. Dr Kathryn North and Dr Llewelyn Davies, from the Royal Prince Alfred Hospital, said the headaches invariably started within an hour of her completing classes and did not improve when she switched from a ‘high impact’ to a low impact’ exercise scheme. They feared initially that the woman, aged forty-eight, had a brain tumour. On further questioning her, the doctors realised that the onset of the post-exercise headaches coincided with a switch from oestrogen pills to patches. They suggested that the woman’s aerobic activities were expanding the blood vessels under her skin, resulting in increased absorption of the hormone and the triggering of her headaches.
To test the theory, the woman removed the patch before each of her next six aerobic classes and the headaches ceased. When she exercised while wearing it, the headaches returned. ‘Aerobics classes are popular in urban Australia’, Drs North and Davies said in a letter to the international medical journal the Lancet. ‘With the increasing use of transdermal oestrogen replacement therapy in postmenopausal women, this unusual headache may occur more often. Instruction from the pre-scriber will limit this disabling complication.’
There is a specified-purpose Pharmaceutical Benefits listing in Australia at approximately $15 a month for women who cannot tolerate oestrogen by mouth. Private prescriptions cost between $28 and $42 a month, depending on patch size.
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