Hormone Patch vs Hormone in pill form

My doctor wants me to change from using Cenestin to the Vivelle Hormone patch.    Is the patch a better choice for women who are in menopause?  Does a patch deliver the same amount of hormone as a pill?  Are there any advantages to using the patch verses pill form?  I should also mention that I had a total hysterectomy and I am concerned about gaining weight with the patch.  Thanks!

[Machelle Seibel, MD]

A. The best thing to do is to ask your doctor why he or she wants to change you to the patch.  Neither is absolutely better than the other.  The amount delivered can be rather similar depending on the strength of the hormones you use as they come in different dosages. The actual doses differ because one is absorbed through the intestines and the other has to be absorbed through the skin. There is some evidence that the patch might have a slightly lower risk of blood clots because it does not go into the intestinal tract and bypasses your liver.  Weight gain should not differ between one form of estrogen and the other.  Your best bet is to talk about this with your doctor so you can understand what they were thinking.
Machelle M. Seibel, MD