The end of the HRT patches

I’ve been on HRT for over four years and, for most of that time, I’ve been using HRT patches. But the HRT patches are now no more for me!

I found the patches pretty convenient. You only have to change them twice a week and for the rest of the time you can forget about them. The small downsides were that they left sticky marks on my leg – I always had the remnants of the previous four or five patches on my legs – and they sometimes came off when I was running in the heat.

Oh, and sometimes they caused little red spots or lumps.

Bad skin is my thing. I’ve suffered from acne since I was 12 and eczema for as long as I can remember. I’ve also suffered from rosacea. So a few small red spots on my legs weren’t going to bother me. Occasionally I did wonder whether I should see the doctor about them and whether I should maybe switch HRT treatment.

But these are post-Covid times. NHS under the worst pressure in its history times. No doctor needed to see a perfectly healthy 49 year old woman about small red lumps on her legs caused by her HRT patches.

Then some of the lumps formed a bigger patch of bad skin. Sometimes it was red, sometimes dry and scaly. It was there for about three months. Again, I ran through the doctor scenario in my head, but I remembered the NHS advice. See the pharmacist.

So I saw the pharmacist.

He gave me some steroid cream to use for a week. I used it for a week and the sore skin improved. It didn’t go away completely, but it improved.

Then it got worse again.

A week after I’d stopped using the cream, it was worse than before. So I saw the pharmacist again.

Use the cream for two weeks.

This time he said that if it didn’t improve after two weeks to make an appointment with the doctor. Knowing that an appointment with the doctor is always three or four weeks away, I made one at that point, thinking I could cancel it if I needed to.

This time, the steroid cream made no difference. But I kept using it for two weeks, just in case. I had new red marks which were spreading of their own accord. And even red marks which had appeared without me wearing an HRT patch. By this time, I was only wearing the patches on the other leg.

I got to the end of my two weeks on the cream and it was just five days until the doctor. The bad skin was spreading. It was swollen, bleeding and leaking sticky liquid. I couldn’t wear leggings or jeans. I had to run in shorts (I never run in shorts in summer). I had to put my trousers in the wash every day as they were getting so sticky. Some of my pyjamas were even too uncomfortable to wear.

When I finally saw the doctor, she was horrified by my skin. She said I should have made an emergency appointment days earlier. (Who knew? My head was just too full of ‘don’t put pressure on the NHS’ messages.) She actually took a photo of it to send to the dermatology department in the hospital for advice or in case they wanted to see me.

She thinks it’s probably eczema combined with a fungal infection. I’ve got a follow-up appointment in four weeks and I’m under strict instructions to see the duty doctor in the next few days if it doesn’t improve.

I’ve been prescribed the very strongest steroid cream (the stuff I had from the pharmacy was moderate) to use for two weeks. I’ve also got antifungal tablets, which I have to take every day for weeks.

So far, so good though. It still looks dreadful, but it looks slightly less dreadful, and it isn’t quite as sore. My trousers aren’t getting in quite such a mess now.

But, needless to say, my HRT patch days are well and truly over.

Instead, I’ve got a gel, which I used briefly years ago when there was a shortage of the patches. The recommended dose is two pumps of gel, but the doctor told me that sometimes ‘younger ladies’ (and I am still classed as younger) need three or four pumps. After only two nights, I woke up sweating a bit. My sleep was also very unsettled from 3am with some vivid and nasty dreams. I thought it might be a blip, but if it happened again, I would increase my dose to three pumps.

On the whole, the gel is fine though. I have to use it every day. The only thing I don’t like is that you have to leave clothes off it for five minutes after applying. When I used it before, I put it on my thighs and was happy to walk around in just a pyjama top and knickers, as my family were all in bed anyway. I’m banned from putting it on my thighs and have been advised to put it on my stomach. I don’t feel comfortable walking round the house topless, just in case my family unexpectedly get up, so I’m trying to work out the best time to use it for minimum inconvenience.

But I will work it out. The important thing is giving the skin on my leg a chance to heal and avoiding it happening again.

And I’ve learned a lesson. Sometimes it’s OK to go to the doctor. The doctor isn’t just there for old people, vulnerable people and people with disabilities. Sometimes the doctor is there for me too. I’m not less important because it’s ‘only’ skin.