There are different types of delivery systems of progestogens that can be used in addition to an estrogen patch, including pills, injections, and patches, among others.Research has suggested that estrogen plus progestogen therapy may increase the risk of heart attacks, stroke, breast cancer, blot clots, and dementia in postmenopausal women. Taking the lowest effective dose of both estrogen and a progestogen may reduce risks. Administration
Depending on the brand, patches are applied to the skin once or twice weekly. Patches should be placed on clean skin where hair and moisture is not present. Preferred areas of application include lower abdomen, hip, and buttocks. Patches should never be applied to the breasts. To reduce the risk of the patch detaching from the skin and skin irritation, skin care products, sun exposure, damaged skin, and tight-fitting clothing should be avoided where the patch is placed. Side effects
Headache, breast pain or tenderness, nausea, vomiting, hair loss, vaginal discharge or irritation, and mood changes are some of the common side effects that may occur while using an estrogen patch. More serious side effects may include fever, loss of appetite, joint pain, difficulty breathing or swallowing, and yellowing of the skin or eyes.Seeing a health professional regularly, taking progestin, having pelvic and breast exams, lowering blood pressure, and lowering cholesterol may reduce the likelihood of developing severe side effects while using an estrogen patch.
Reverse culture shock
Reverse culture shock (also known as "re-entry shock" or "own culture shock") may take place—returning to ones home culture after growing accustomed to a new one can produce the same effects as described above. These are results from the psychosomatic and psychological consequences of the readjustment process to the primary culture. The affected person often finds this more surprising and difficult to deal with than the original culture shock. This phenomenon, the reactions that members of the re-entered culture exhibit toward the re-entrant, and the inevitability of the two are encapsulated in the following saying, also the title of a book by Thomas Wolfe: You Cant Go Home Again. Reverse culture shock is generally made up of two parts: idealization and expectations. When an extended period of time is spent abroad we focus on the good from our past, cut out the bad, and create an idealized version of the past. Secondly, once removed from our familiar setting and placed in a foreign one we incorrectly assume that our previous world has not changed. We expect things to remain exactly the same as when we left them. The realization that life back home is now different, that the world has continued without us, and the process of readjusting to these new conditions as well as actualizing our new perceptions about the world with our old way of living causes discomfort and psychological anguish. Outcomes
There are three basic outcomes of the adjustment phase:
Some people find it impossible to accept the foreign culture and to integrate.