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The following ‘Ask the Experts’ questions were sent in to The Menopause Exchange by our members, the answers were provided by our ‘Ask the Experts’ panel and included in issue 83 (winter 2019-20) of The Menopause Exchange newsletter.  If you would like to read the questions and answers in the latest issue of The Menopause Exchange newsletter sign up for FREE emailed newsletters.

Please can you give me advice on how and where to apply HRT patches, how to remove them and is there anything else I should know when I’m using them?

Dr Nuttan Tanna, pharmacist consultant (women’s health & older people), replies:

The patient information leaflet that comes with your HRT patches will explain in detail how to use your particular patches. Generally HRT patches are applied to the lower part of your body, around your trunk area or thighs. It’s important not to apply the patch on your sitting bone, as this will affect how well the patch sticks to you. When you take off the backing to the patches, try not to touch the glue as this may also affect how well the patch sticks. The patch needs to be applied to dry, clean skin. If you use a moisturising cream, you can use the cream on surrounding skin after you’ve applied the patch. When you take off a patch and use another one, don’t apply it to the same spot, as this will cause skin irritation; use new sites for each patch. You can use baby oil or warm olive oil to gently ease the patch off or you can buy products to help, such as Zoff adhesive remover, from a community pharmacy or online. If you get slight skin irritation at the area of the patch, use hydrocortisone cream or Savlon cream to soothe your skin. If the skin irritation is very bad, speak to your GP about changing your HRT regimen. It’s important to make sure you’re using the patches correctly, in the correct order, as advised on the pack.

Are hot flushes worse at different stages of the menstrual cycle?

Kathy Abernethy, senior nurse specialist, replies:

For many women, flushes seem to happen most at times of hormonal ups and downs, often starting before a woman sees a change in her period pattern. During the months and sometimes years before the menopause, hormonal levels will vary widely at different times of the cycle; just before a period seems to be when flushes can be worse. Once a period comes, symptoms may subside, at least for a while. If you miss a period or two, flushes
may be worse, again getting better when the period finally arrives. Eventually hormonal levels settle a little and for most women, but not all, the flushes will ease. There are some women, so-called ‘late flushers’, whose flushes are worse once periods stop. Every woman is different.

What is the difference between vaginal lubricants and vaginal moisturisers? And can you give me any examples?

Dr Kathryn Clement, consultant in sexual and reproductive healthcare, replies:

Vaginal lubricants are gels that lubricate intimate tissues and are most often used during sex when there’s vaginal dryness or soreness. The effects tend to be short-lived and some of the older varieties, unfortunately, can leave a sticky or tacky feeling as they dry. Some lubricants contain oil and can weaken condoms. Examples include KY Jelly, Durex Play range, Yes WB, Yes OB and Sylk.

Vaginal moisturisers help with dryness but are designed to last longer so they can be applied every now and again. They can ease symptoms straight away but using them regularly may give long-lasting relief. Some products are available on NHS prescription and many can be bought in pharmacies or online. These are a good alternative for women who can’t use vaginal oestrogens for medical reasons, such as breast cancer treatment. Examples include Replens MD, Yes VM, Canesintima Intimate Moisturiser.

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