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Going higher (combining patches, using larger patches off-label) is rarely useful because: Hot flash response plateaus around 0.075-0.1 mg/day for most patients

As demand has grown, so have the risks

You should contact your health care provider immediately if you suspect that you have a medical problem

High concentrations of IGF-I were associated with an increased risk of prostate cancer (odds ratio comparing 75th with 25th percentile 149, 95% CI 114195) and premenopausal breast cancer (165, 126208) and high concentrations of IGFBP-3 were associated with increased risk of pre-menopausal breast cancer (151, 101227)