I’d Be Lost Without My Estrogen Patch
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Photographed by CARLOS and ALYSE. Stylist: Fiona Green. Hair: Jenni Iva Wimmerstedt. Makeup: Andrew Colvin. Manicure: Elina Ogawa. Model: Brandi Quinones.
I made a decision many years ago: I wasn’t going to go through menopause. Hot flashes, night sweats, mood swings, brain fog—this didn’t sound like a party. I figured I’d skip it.
For a long time it looked as though my plan would work: I was in the latter half of my fifties before I had a single hot flash. Then I had another one. And then—I think you know where this is going—I had another one. (True, I hadn’t had my period in almost a year, but hadn’t my cycle always been erratic?) My master plan had failed! But this didn’t mean I was going to go sweatily into that bad night.
For two decades, I was in great hands with my general practitioner, a woman a few years older than I am who, I assumed, would be there to tell me what was around the corner, including menopause-wise. Well, last spring she had the nerve to retire early. This turned out to be only four months before my hot flashes came on like a vengeful ex. Faced with a replacement GP who didn’t look old enough to menstruate, I decided that within my multi-location Boston-area healthcare practice there simply had to be an ob-gyn who specialized in treating menopausal symptoms. And there is! (Not everyone has my good fortune, though: A 2023 survey found that only 31.3% of ob-gyn residency programs include menopause training. I was very lucky to find a bona fide expert.)
I booked a televisit with Martha K. Richardson, MD, a board-certified obstetrician-gynecologist, for whom menopause education is a passion. “Pediatricians discuss adolescence, there is lots of childbirth education, and there’s almost nothing in the clinical setting preparing women for menopause,” she would later tell me. During our appointment, I asked Dr. Richardson for whatever would stop the near-hourly hot flashes—hot seizures, I had taken to calling them. By keeping me from sleeping through the night, they made me feel, in one of life’s more thoughtless ironies, like an infant. As I expected, she suggested hormone therapy (also known as hormone replacement therapy), which I had always understood was the go-to for unhappily menopausing women.
Just so you know, I wasn’t blasé about turning to hormone therapy, which is the process of adding back some of the hormones the body has stopped producing. I have always been annoyingly abstemious as far as drugs, alcohol, and medicine go—I’ve never even been on the birth-control pill, disliking the idea of a regulated period when mine had always been renegade. “Baby steps,” I said to Dr. Richardson, meaning that I wanted the lowest possible dose of hormones to start with.
She had just the thing for me: a weekly patch of estradiol, which delivers the main estrogen made by the ovaries during our reproductive years. “Many clinicians prefer the patch [to the pill] because it goes directly into the circulation and bypasses the liver,” says Dr. Richardson. “This is thought to reduce the risk of blood clots—a serious risk seen with oral hormones, which go through the GI tract to the liver.”
The day after my televisit I filled my prescription, slapped on the patch, and after a few days, my hot flashes were gone. As Dr. Richardson puts it, “Many women find the effects of a low-dose estrogen patch just short of miraculous.”
My patch is a little miracle. It looks like a Band-Aid with magical healing properties—it’s as though my hot flashes never happened—and I’d be lost without it. Here’s something embarrassing: I know that after each patch has run its one-week course I’m supposed to throw it away, but I figure that if I ever run out of new ones in the middle of a national shortage I can reapply a few from my sad stockpile in hopes that whatever residual juice may be inside them can tide me over. (Dr. Richardson tells me there’s no reason to believe that an old patch would be effective. Even so, I find the sight of my stash reassuring.)
Syncing up with my first hot flashes was the news that Naomi Watts was writing a book on menopause: Dare I Say It: Everything I Wish I’d Known About Menopause, which came out on January 21. I got an early copy and spent two days nodding along with just about everything Watts said. What interested me most—and by now this shouldn’t surprise you—was her experience with the patch.
Watts writes that when she was about to have sex for the first time with actor Billy Crudup, whom she would go on to marry, “I went into the bathroom before getting naked and furiously attempted to scratch the hormone patch off my body.”
I had the opposite problem: My first two patches came off of their own accord before time was up. The first patch that fell off had been on my butt, one of three permissible canvases for estradiol patches, the other two being abdomen and thigh. I considered my abdomen, but I didn’t think the patch would have a fighting chance on my burst-balloon-like post-childbirth belly skin. Now, as much as I don’t adore having to look at the patch in its new location—the front of my upper thigh—at least I can keep an eye on it. And I’ve taken to wearing tights to pin the patch in place, aware that I may have to reevaluate this strategy when it’s 80 degrees out.
Reading Dare I Say It, I felt grateful that I managed to forestall menopause for as long as I did. For Watts, menopause struck when she was in her early 40s, and she writes about her big confession to Crudup before that first sexual encounter: “Suddenly the words came gushing out, ‘I wear these hormone patches, and I didn’t want you to see it because then you would know I’m in early menopause, which means I am old, and you wouldn’t want me and, Oh my God, should I just leave?’” Me, I had been married for almost a quarter century when I started patching, so my husband not only knew that the jig was up but supervised my first patch’s application. Yes, the one that fell off my butt.
I should say here that there’s an easy fix for the wayward hormone patch: Dr. Richardson told me about Tegaderm, a protective adhesive dressing that goes over bandages and such to secure them in place. I’m willing to admit that this makes better practical sense than my tights-all-year-round solution, and I did inspect a box of Tegaderm at my pharmacy. But Tegaderm seems so…medical, whereas here I am trying to steer away from the idea that menopause is a disease. And I do understand that referring to my patch as my pacemaker doesn’t help the cause.
For readers of Dare I Say It, Watts is like a good friend who’s there to walk and talk us through menopause. But as luck would have it, I have an actual friend who’s going through menopause in lockstep with me. When I saw my menopause buddy last fall, I asked, “Do you notice anything different about me?” When she said she didn’t, I told her I was wearing a hormone patch. I may have even done “ta-da” arms and twirled in place. And now we’re twinning: Last month I got an email from her that said, “Have been loving my patch!”
Anyway, I’m feeling a little giddy about having made the right call, at least for me, by going with the hormone patch, which so far has no side effects other than the cessation of my mortal dread that bedtime will hold a sleepless night. Following a lifetime of skepticism about putting anything unnecessary in (or on) my body, I’m now a person who would kneecap anyone standing in the path between me and the pharmacy filling my estradiol prescription.My fear of taking hormones was easily vanquished by my superior fear that I would never again sleep through the night. Now, I’m pleased to report, all I fear is that my patch will come off in the shower.
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