Let’s Talk Patches, Hormones, and HRT with Dr. Rebecca Poet

If you’ve ever struggled with hormone replacement therapy (HRT), particularly when it comes to patches, irritation, them falling off, or just figuring out which kind to use, you’re not alone. We recently had the pleasure of chatting with Dr. Rebecca Poet from the Women’s Hormone Clinic, who generously shared her time and expertise to answer all those burning questions about patches, gels, and more.

Meet Dr. Rebecca Poet

Dr. Poet runs the Women’s Hormone Clinic, an online-only practice based in Brighton that helps women across the UK. After years in the NHS, she created the clinic to give women easier access to longer appointments, continuity of care, and faster treatment, something she found lacking in traditional settings.

“Continuity is probably the most important thing to increase patient experience and satisfaction,” she says.

Why Hormone Health?

Dr. Poet’s journey into hormone specialism came naturally. As a GP, she found more and more women coming to her with hormonal concerns, and she had a knack for listening, understanding, and making a difference.

“These things are self-selecting… You get a reputation for listening and delivering good care.”

It’s Not One-Size-Fits-All

Whether you start with a patch, gel, spray, or oral estrogen really depends on your lifestyle and medical history.

• Patches might be great for swimmers or busy people who need something low-maintenance.
  
• Gels can be a bit more fiddly, especially in cold weather when drying takes longer.
  
• Oral estrogen is still an option for many, though less common due to its slightly higher clotting risk.
  

“Once we’ve established what’s safe, it’s about giving women all the options and helping them decide based on their lifestyle.”

The Patch Problems: Falling Off, Skin Irritation & Absorption

We know the struggles! From patches peeling off mid-week to skin reactions, many women face these annoying issues. Dr. Poet had some top tips:

• Skin irritation? It’s likely the adhesive, not the estrogen. Try a different brand or use a steroid asthma inhaler spray (yes, really!) before applying.
  
• Patch falling off? Don’t add sticky plasters, try warming the patch slightly before application and make sure your skin is clean and dry.
  
• Patch came off early? You can either adjust your routine or sacrifice a patch to keep things consistent by applying a new one in its place.
  

And yes, absorption might change over time, due to skin fatigue or colder weather drying out the skin. Blood testing (more accessible in private practice) can help pinpoint if your levels are dipping.

Gel Talk: Where, When, and How Much?

The gel requires a bit more planning, especially in winter. Dr. Poet recommends:

• Apply to thighs (rather than arms) to reduce breast tenderness.
  
• Rotate legs if using one pump, split into two daily doses if using more.
  
• Let it dry properly before dressing, and definitely before cuddling partners, pets, or kids.
  

“Sensible hygiene is key. Wash hands after applying and allow it to dry before skin contact.”

What About Testosterone?

Many women don’t realize testosterone plays a crucial role in HRT too. While male and female testosterone are chemically identical, the key is getting the dose right.

• The sachets can be frustrating, leaky, hard to dose, and prone to drying out.
  
• A compounded cream might be a more user-friendly solution (available via private prescription).
  

“Too much testosterone can make you greasy, spotty, and irritable, so dose matters!”

Switching Products During Shortages

Patch shortages are a real headache, particularly with EstroDot. If your pharmacy can’t fill your prescription, talk to your doctor about switching to:

• A different patch brand (same strength)
  
• Gel or spray (with adjusted dosing)
  

“Just don’t wait until you’re on your last patch to check if it’s in stock!”

Do You Cut Patches? Only If You Have To

In an emergency, yes, you can cut a patch in half. Dr. Poet recommends cutting corner to corner (diagonally) for the most even distribution. Just be aware the cut edge may not stick as well.

How Long Can You Stay on HRT?

Gone are the days of the “five-year limit.” Now it’s all about personalized care. As long as you’re feeling the benefits and there are no contraindications (like hormone-dependent cancer), you can stay on HRT indefinitely, with annual reviews.

“We see women every year to check everything’s still working for them, safely.”

Progesterone & the Coil

If you’re using a Mirena coil with your estrogen patch, rest assured, it’s enough protection for most standard doses. Only women on very high doses might need a tweak to their progesterone. And remember: irregular bleeding is a red flag and should be discussed with your doctor.

Final Tips

Dr. Poet encourages women to:

• Stick to regular patch/gel routines (reminders help!)
  
• Understand why each part of their HRT is important
  
• Speak up when things don’t feel right, you know your body
  

Exclusive Discount from Dr. Poet

Dr. Poet and her team are offering 20% off first appointments with the code NUDI20—available with any of the five clinicians in her online clinic*. You can find more info and book via the Women’s Hormone Clinic website. www.thewomenshormoneclinic.co.uk

*All appointments must be booked and paid for by 31st May 2025

Want to learn more or book an appointment? Visit the Women’s Hormone Clinic to check out their symptom checker, patient journey, and make an appointment.