These may be alleviated by taking the progestogen in divided daily doses or at bedtime, or by changing the type of progestogen. It might be necessary to consider the use of another source of progestogen. While oral oestrogen is the most commonly used form of HRT in the UK, many women prefer the patch regimen and it has become increasingly popular, although it is more expensive. The oestrogen is delivered through the skin at a constant rate and it is absorbed into the circulation. The patch must be changed once or twice weekly and many women find this method easier to comply with than a daily oral treatment.
Women using patches occasionally suffer skin irritation.
This can be minimised by changing the patch site. Recently, newer matrix patches have been produced which appear to cause less irritation. These are available in a variety of strengths which release from 25 to 100mcg of oestradiol every 24 hours which gives some flexibility to the dose to be administered. Progestogens are also available in a patch form and can be administered in sequential or a continuous method combined with the oestrogen patches. Percutaneous oestrogen Percutaneous oestrogen can be used by application of an alcohol based gel to the skin over the abdomen or thighs.