I am not happy with the topical estrogen ( strength seems ...

I assume you are taking Estrogen for hormone replacement.

Topical Estrogen is considered a safe and effective long term delivery system, because it bypasses the liver and is better utilized by the body. The topical form is a steady, gradual absorption and may produce less noticable changes day to day than the surge of estrogen you get from the oral form. Studies do seem to indicate better symptom control with the oral estrogen.

However, there are factors that can interfere with the topical's absorbtion. skin irritation, dryness, scar tissue, excessive sweating (ex:during hot flashes) or oily skin will not transport it as effectively. The vaginal ring delivery system is subject to the same limitaions. Hormaonl fluctation and normal bodily function can compromise uptake.

As for comparioson of gel vs ring both are effective and carry equal risks and benefits. I think it is a matter of preference and your Doctor's opinion.

You have some say over the form your therapy takes. Don't be afraid to speak up and request directly a change to the form you preferred. If the Doctor truly feels one form is better or another is counterindicated he'll simply say so- but at least you'll know gis reasoning.

Best of luck.

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Positive feedback and any bonus would be appreciated. Thank you, Christy

My question was concerning oral vrs topical. I asked what studies, if any, suggest that the benefits of topical largly out weigh the oral method. I understood from the beginning that the topical by passes the liver...but no one has said that there is evidence that that is a vastly important difference and tells why. So far no one, includigng my doctor can come up with statistics in favor of topical. Therefore, I will continue to choose what works best for me. But thank you for your note. Obviously, there is little information out there on this subject.

I apologize for missing part of your question.

The bypassing of the liver is a factor in absorbtion, but it is also one frequently cited benefit of topical vs. oral because long term oral use can damage the liver. Oral estrogen's pass through the liver also increases incidence of blood clots and gall bladder disease.
While oral estrogen improves calcium absorbtion better than topical, (a good effect)it can also interfere with some medications causing them to be over or under absorbed and more toxic to the liver. These include common meds like some antidepressants and antibiotics and coumadin.

Oral estrogen can cause an increase in triglycerides where transdermal does not.

A very recent study showed oral estrogen increase a protein in the bood called c-reactive protein which is a major risk factor for heart disease.

Oral estrogen also effects the free testosterone level in the blood stream which can inhibit libido.

Transdermal estrogen avoids or limits all of the negative effect I listed. The most current research results back this up with very convincing data.   For this reason topical is now considered the gold standard of HRT.

I hope this was more on point. Of course women have taken oral for yrs and thrived, so I agree with you: you must choose what works for you!

Best wishes and good luck.

__________________
I hope my information is helpful. If you have more questions, just ask! I will gladly help, otherwise please click "accept".
Positive feedback and any bonus would be appreciated. Thank you, Christy