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Vivelle-Dot (estradiol): My doctor prescribed Vivelle dot patch 1.0 for me right after total hysterectomy 10 years ago. In recent years, dose was lowered to 0.075, then 0.05. Two months ago, I stopped taking it altogether without doctors permission (my doctor closed her practice). I tried to quit before but was not successful because I always got dull headaches. I was, however, able to stay off of it this time but experienced hot flashes and dull headaches. I never knew what hot flash was before. I started back on patch again and I feel much better - no more hot flashes and headaches. Now, I see that there is even a lower dose, I will ask my next doctor to prescribe me lower one yet.



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It requires higher doses of estrogen and is riskier than the current standard of care.

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The compensatory hyperinsulinemia further stimulates ovarian androgen production which may be detrimental to egg maturation and there is a clear link between the degree of insulin resistance and anovulation.

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This regimen started with normal doses of estrogen and anti-androgen, then increased the anti-androgen above normal dosage by adding another, less effective anti-androgen.

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