The content of this podcast is provided for general informational purposes only and is not intended

as, nor should it be considered a substitute for professional medical advice.

Oh, how I feel.

Bitchy, bitchy, bitchy, bitchy, itchy, bitchy, itchy, itchy, itchy, bitchy, itchy, itchy and bitchy.

Hello, this is Karen Nicol family nurse practitioner, and you are listening to Itchy and Bitchy,

a podcast that provides answers to your many unanswered health questions.

Over the years, women in menopause have asked me to share with them the best option to replace estradiol, the form of estrogen that is

normally secreted by our ovaries, which is better, oral or topical estradiol? Since this conversation

keeps popping up, I'm going to share with you why a topical form of estradile might be your best choice.

Topical, also known as transdermal estradile, may have advantages over oral estradile because

by using a topical form, first pass metabolism through the liver is avoided, which can

lead to a lower risk of blood clots,

lower risk of gallstones, and stroke. Transdermal methods can also lead to a more stable

hormone level and a lower risk of side effects like weight gain and breast tenderness. However,

oral estradile may be more effective for some women in

relieving menopausal symptoms. Let me first explain what is meant by first pass metabolism.

When drugs are taken orally by mouth, they must first pass through the stomach, intestines, and then the liver

before the drug reaches the bloodstream and finally reaches the target tissues. As a result,

much of the drug dose has been reduced in this process, which decreases the amount of drug you're actually getting, as well

as decreasing the drug's effects. The first pass effect can be bypassed by using topical

forms of medications. Transdermal meds are first released from whichever form is being used, for instance, a patch,

gel, or cream, and then dissolves on the skin's surface. The drug then enters a specific

...