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Oestrogen Patches for hormone treatment

User
Posted 26 Mar 2026 at 20:38

In today's newspaper was an article about the benefits of Oestrogen Patches as compared with hormone treatment for locally advanced cases.  The outcome being similar except the patches had lower side effects.  A link below sums it up:

https://www.ucl.ac.uk/news/2026/mar/hormone-patches-effective-locally-advanced-prostate-cancer

 

User
Posted 26 Mar 2026 at 22:19
They used to prescribe the tablet form of oestrogen many moons ago before LRLH agonists were invented, I wonder if the inventors of Zoladex screwed the trial data to prefer the expensive "new" wonder drug?
User
Posted 27 Mar 2026 at 00:04

I've seen this before. I think there was a trial of it here. It's possible used by some in the US 

User
Posted 27 Mar 2026 at 21:55
Interesting. As I understand it prostate cancer cell growth is testosterone-dependent rather than oestrogen-inhibited. Which means it may work by acting on the testes to reduce testosterone production.

It sounds as if it has a slightly different mix of side effects from the usual LHRH agonists, like the direct effect on breast tissue. It may be the side effects which decide its usefulness in clinical practice - including how easily normal hormones return after treatment.

User
Posted 28 Mar 2026 at 21:44

Really interesting thank you. I hope this becomes available in the near future 

User
Posted 29 Mar 2026 at 17:54

Originally Posted by: Online Community Member
They used to prescribe the tablet form of oestrogen many moons ago before LRLH agonists were invented

This was Diethyl Stilbestrol, a synthetic estrogen, which was the first hormone therapy drug.

Diethyl Stilbestrol is given orally (tablet), and drugs taken orally do what's called "first pass through the liver" to process toxins the same as all other nutrients you eat, to make them suitable for you body before they go into your normal blood circulation. It turns out that estrogens doing this "first pass through the liver" mess up the liver's generating of clotting agents, and long term on oral estrogens generates a significant risk of blood clots. This was a significant cause of death back when Diethyl Stilbestrol was the only hormone therapy drug, hence the switch to Zoladex and the others which have come along later, which are not estrogens.

Diethyl Stilbestrol is still used occasionally when all other ADT medications have stopped working, and it's usually given with Asprin too now.

The key thing about using Estradiol patches is that they are absorbed directly into the blood stream and don't do the "first pass through the liver", so don't have the blood clotting risk which oral Diethyl Stilbestrol does.

Edited by moderator 29 Mar 2026 at 18:04  | Reason: Slight rewording

User
Posted 29 Mar 2026 at 20:43
Thanks Andy for that fascinating explanation. Does estradiol directly inhibit prostate cancer cells, or does it work by reducing testosterone synthesis?

Hope things are well with you, I haven't spotted you on the forum for a few months - and I do take notice of your posts because they are so often very informative.

User
Posted 30 Mar 2026 at 01:15

Estrogens reduce Testosterone generation. This appears to be because the negative feedback loop which sets your Testostertone level (called the HPG-Axis) is sensitive to both Testosterone and estrogens (same mechanism sets the estrogen level in women). So if you have enough Testosterone+estrogens, it shuts down the production of Testosterone (in men) or Estradiol (in women).

I recorded a talk/webinar on how the HPG-Axis works and how the various different hormone therapy medications interact with it, including even Diethyl Stilbestrol:
How Hormone Therapy Drugs Work

 

User
Posted 30 Mar 2026 at 12:00

Thanks for the background Andy, I should have realised the blood clotting risk as I had learnt that from researching my wife's HRT regimen 

 
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