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A quick question about estrogel...

(67 Posts)
Coffeefacescrub Thu 05-Jan-17 08:37:02

Hello,

I have to do one pump a day of estrogel. When is best - morning or evening? I have sleeping issues, in that I wake at least once or twice a night and find it very hard to get back to sleep. I don't want to make it worse.

PollyPerky Thu 05-Jan-17 10:15:53

Hi It really shouldn't make any difference.
Hormones don't work in the same way as say paracetamol- they don't have a 'window of a few hours' where they work. They will build up slowly in your bloodstream until after a few weeks you ought to have a constant level.

I use 2 pumps and do one morning, one at bedtime. Partly so there isn't so much to spread in one application but also to give a steady level.

You may have to experiment and also think about increasing to 2 pumps if 1 doesn't help.

Coffeefacescrub Thu 05-Jan-17 11:08:11

THanks Polly. That's helpful. My doctor has prescribed one pump, so I doubt I'll do anything without their agreement

PollyPerky Thu 05-Jan-17 11:18:35

May I ask why you've been prescribed 1 pump (only)?

The dose is 2 pumps. This gives 1.5mgs of oestrogen which is a low-medium dose. (Pills and patches come in 1mgs and 2mgs doses.)

One pump gives 0.75 mgs which is very low.

I was advised by my consultant to begin with 1 pump and see if it helped. I was told I could adjust the dose to whatever was needed to get symptom control. I used 1 pump for around 3 weeks and got rid of the flushes, but not the insomnia so I upped to 2 pumps and have been on that for 8 years.

Low dose HRT is recommended for women starting it over age 60, but my consultant's view is 'if you're going to use it, use it properly, to get results.'

I suspect your GP is being over cautious, not being a specialist.
what do you think?

Coffeefacescrub Thu 05-Jan-17 11:27:03

I don't know. It was just what I was prescribed.

Coffeefacescrub Thu 05-Jan-17 11:29:06

Actually, maybe I've misread. The chemist instructions says, 'apply once daily,' but in the inside info say 'the usual dosage is 2 measures of gel.'

Maybe doc means 2 pumps, once daily?

PollyPerky Thu 05-Jan-17 11:31:38

It's possible your GP doesn't even know what the standard dose is.

One canister has enough for 2 months if you use 1 pump a day.

If you get on fine with 1 pump, that's great. If you don't, then I'd contact your GP and ask why he has put you on half the recommended dose (the leaflet in the pack tells you that the standard dose is 2 pumps and can be increased to 4 pumps a day.)

Don't just accept what they have said without asking, if it's not the right dose for you.

PollyPerky Thu 05-Jan-17 11:33:15

Sorry x posted.

Yes, applying once daily means you use 2 pumps.

Some drs suggest doing what I do- splitting the dose morning and evening. I did this because 2 pumps at once gave me 'morning sickness' nausea in the first few weeks, so I just made a decision to split the dose, which worked!

Coffeefacescrub Thu 05-Jan-17 12:59:37

Thanks a lot. I'll give twice a day a go!

NK346f2849X127d8bca260 Thu 05-Jan-17 13:25:12

I use three pumps a day. two at night and one in the morning.

Coffeefacescrub Fri 06-Jan-17 11:44:51

Thanks all. I did a pump at night too and it seemed fine.

Out of curiosity, when does one start to feel the positive impact of this oestegel and also the mirena? How quickly?

Aroundtheworldandback Sat 07-Jan-17 22:17:15

NK I also use 2 at night and one in morning. Am 49. Works for me..

PollyPerky Sun 08-Jan-17 08:25:53

Coffee- I think it's very individual. I found it worked for me in about a week, other women say weeks and weeks or months.

twarno Sat 30-Jun-18 12:12:01

Hi ladies I’m on Evorel Conti .. can I add a pump of Estrogel as my oestrogen levels are very low .. maybe two pumps one am and one pm .. I’ve tried lots of hrt tablets and none of them suit me .. just want to make sure I can still use Estrogel while I’m on Evorel Conti ?

Discoisabelle Sat 30-Jun-18 12:41:37

Twarnonyes you can to increase the dise of oestrogen, i did it for about a year by taking femoston 1/10mg and adding 2 pumps of oestrogel a day, made things much better.

twarno Sat 30-Jun-18 13:31:19

Thanks so much for your advice do you think it’s safe to do one pump in morning and one in evening plus wear my Evorel Conti patch my oestrogen is very low x

twarno Sat 30-Jun-18 13:34:45

Sorry I meant to say to split the pump to morning and evening 😂

QueenoftheNIghts Sat 30-Jun-18 15:42:37

@twarno Has your doctor prescribed this top up? (Assume they have to you'd not have the gel)

First question- why can't you increase the dose via a patch?

2 pumps is the standard dose for gel ( 1.5mgs)
You might be best adding 1 pump for a few weeks to see how that works. The other issue is that the amount of progestogen in the patch may not be high enough for a higher estrogen level.

How do you know your levels are low and is this why a dr has given you gel as well? (I don't know why you are asking on a forum if this has been prescribed...???)

twarno Sat 30-Jun-18 17:41:01

Hi the doctor prescribed Estrogel on a previous occasion with uvestrogan but it didn’t agree with me so I went back to Evorel Conti I had blood tests that confirm my low levels of oestrogen after research I just read I can add Estrogel along with Evorel Conti I’m willing to try it even though the doc not adviced it as I’m not back there for two weeks it just feels that my patch runs out before the change day I did discuss that with my gp on my last visit thanks

QueenoftheNIghts Sat 30-Jun-18 18:04:06

I just read I can add Estrogel along with Evorel Conti

Not sure where this would be online- can you link? (You mean another poster?) Why not change your patch a day earlier or ask for a higher dose? The progestogen in a conti patch is measured to balance the amount of estrogen. I don't know if more estrogen would necessitate more progestogen. You need to follow a dr's advice.

twarno Sat 30-Jun-18 18:17:44

Hi
Yes it was what another uses had done .. I’ve tried so many Hrt and struggled with them .. this is my second attempt at Evorel Conti as I lasted on this the longest ... I’m just worried if I up my psych dosage then the prigesterobe will be high to and give me more side effects .. would one pump of Estrogel warrant more progesterone ? I still have my uterus and need progesterone too .. thanks for your advice there are so many things to learn about hrt but a lots of forums I have read ladies use Evorel Conti and patches with pumps of Estrogel ..

twarno Sat 30-Jun-18 18:19:24

Phyc was a spelling error 😂😂

QueenoftheNIghts Sat 30-Jun-18 19:26:44

You risk having breakthrough bleeding if they progestogen is not enough (ratio) for the estrogen. A single pump is 0.75mgs. I think a 50mg patch is a medium dose but it's hard to equate a patch to gel.

A better idea would be to use another half a patch and then you would be getting both hormones.

twarno Sat 30-Jun-18 20:41:45

That’s a good idea to cut a patch in half ... do u not think the progesterone in my Evorel Conti patch is enough to cover one pump of Estrogel too?

Bellaciao Sat 30-Jun-18 20:42:13

How low are your oestrogen levels and are you getting symptoms that suggested a blood test was necessary? You said you feel as if your patch runs out - what do you mean by this? I've used patches for years and never felt this - I don't even remember it's time to change except for the fact that I do it the same days of the week! is it sticking correctly? As QueenoftheNights suggests why not try to change every 3 days instead of 3.5 and see how you go?

twarno Sat 30-Jun-18 22:30:23

The gp sent my bloods away as I was having menopause symptoms hot flushes anxiety brain fog.. the test come back and she confirmed my oestrogen levels were low she said I was running on empty testosterone 1-4 oestrogen 82 free androgen 1-7.. after a few days the symptoms started creeping back and I did mention this to gp and she agreed that is seems as if the patch is running out I’m going to menopause clinic in Aug my gp admits that she doesn’t know a lot about hrt I did try changing patch early but it didn’t really make much difference maybe I need a higher dose patch ?

Oxfordblue Sun 01-Jul-18 16:01:36

Maybe you need testogel?

twarno Sun 01-Jul-18 16:55:26

Thanks I may just give the Estrogel and 100mg uvestrogan another go and add a extra pump of Estrogel so one pump in the morning and two at night..I’ve only had hrt patch Evorel Conti on for two days so to change back to Estrogel shouldn’t have a big impact .. I’m going to see doc tomoz just to make sure for three pumps I have the right dosage of progesterone as I’m on 100mg ... do we ever find the right hrt .. it’s seems forever trying all different kinds😂

QueenoftheNIghts Sun 01-Jul-18 17:06:04

My advice is to up the Oestrogel first and not swap to anything else too soon. You can go up to 4 pumps.

Are you on a conti regime? (No bleed)
If so the dose of Utrogestan is 100mgs a day.
If you are having a sequi regime, it is 200mgs for at least 12 days per cycle.

It is better to start with a sequi regime because that allows you to monitor the dose of estrogen before adding in another hormone.

twarno Sun 01-Jul-18 18:20:35

Thank you I’m going to stick with the uvestrogan 100mg and up my Estrogel to three pumps a day.. I’m not going to continue with Evorel Conti patches as the progesterone in them gives me side effects hopefully this uvestrogan will work I take it 25 days then break for three thanks so much for your advice x

QueenoftheNIghts Sun 01-Jul-18 18:24:34

Have you got predictive spelling that' s coming up with uvestrogan? (I've not come across that word before!)

Using Utrogestan for 25 days is in effect a continuous regime with just a 3 day break to allow and lining to come away.

If you are having symptoms still on this regime there is a lot to be said for using it sequentially for 12 days a month.

twarno Mon 02-Jul-18 10:07:12

After a long think I’m staying on evorel sequi and added two pumps of Estrogel .. I’ve had a few good days doing this routine one pump in morning and one at night just got to make sure the progesterone in patch is enough to protect my womb .. I don’t want to up patch as I’m very sensitive to progesterone in it

QueenoftheNIghts Mon 02-Jul-18 12:49:16

That amount of estrogen is getting on towards 3mgs a day. (50mcg patch is a medium dose so adding in 1.5mgs of gel brings it higher.)

How are you going to keep going with this because your GP won't prescribe both?

Gerijrich Thu 19-Jul-18 00:01:04

Having read these posts I have decided to spread my two pumps out to one at night and one in the morning.

Blondie1953 Thu 23-Aug-18 19:19:19

Hi I use the gel but have now been told to use twice a day morning and night as I don’t have a regular time for going to bed and getting up how many hours should I leave between applications?

QueenoftheNights Thu 23-Aug-18 21:08:12

It really doesn't matter- the timing isn't that critical- it stays in your system so in all honesty, don't worry about it. I apply it morning and night. Sometimes that's 8am- 11pm, other days 9am then 11pm, or even 10am them 10pm.

Jago68 Thu 06-Sep-18 00:29:59

hi ladies ,
Another eastrogel / utrogestan question

I’m in the three month cycle as I really can’t tolerate the progesterone

I just have one pump eistrogel a day and that sorts my main symptom which is painful joints ( I couldn’t walk ) I’ve been on this since February . Take 200mg utrogestan for 14 days andmy worry is that it’s not triggered a period.
Any advice gratefully received . The dr doesn’t seem even slightly concerned . I asked about a yearly scan as a double check and she laughed . I don’t feel I need more than 1 pump oestrogel. The lower dose the better , it’s sorted out my joints and mild hot flushes .
Only concern is no withdrawal bleed - will this clause lining to build up ??

India9 Tue 27-Nov-18 20:51:43

I’ve been prescribed 4 pumps a day and no progesterone! Doc suggested Mirena but I’ve changed my mind having heard so many horror stories so I called my doc secretary to ask about the Estrogel and doc said to start on 4 pumps anyway....

Jago68 Tue 27-Nov-18 21:23:54

I was advised to start in lowest dose - one pump at night on inner thigh , I liked it and stayed there

Anita6810 Thu 31-Jan-19 22:43:16

Hi do any of you take a break from estrogel. My doctor said just to use it for 12 days a month worried this is going to cause problems with hormones

Jago68 Fri 01-Feb-19 07:59:32

Yes Anita , is get a second opinion on that . Depends where you are with periods , unless it’s to support egg growth in first half of cycle for fertility ?? That’s the only thing I can think of .

JinglingHellsBells Fri 01-Feb-19 09:12:31

@Anita6810

Completely wrong. You need to correct your GP and consider how to deal with someone who cannot understand basic prescribing guidelines.

You use gel 365 days a year.

Anita6810 Fri 01-Feb-19 17:26:08

Thank you for your comments. Periods have been irregular with 3 or 4 months between for a few years. Been six months since the last period so far. Have to go and speak with my GP I think

JinglingHellsBells Fri 01-Feb-19 17:50:26

Has your dr given you a separate progestogen to use for 12 days each month?

Please don't say no.

If your GP does not know how to prescribe this kind of HRT (ie not simply a pack of pills) I'd see someone else.

It's shocking actually.

If you have picked up your script the instructions are in the pack (gel)

Anita6810 Fri 01-Feb-19 18:19:57

Was put on progesterone first it’s the mini pill that I take everyday to see if it helped with my symptoms. It did help but not with sleepless nights muscle aches night sweats and low mood. I did some research myself and asked the the estrogel which has helped but not all the time as I’m only taking for the 12 days

JinglingHellsBells Fri 01-Feb-19 19:02:06

see another GP. Yours doesn't know what they are doing

Jago68 Fri 01-Feb-19 20:43:13

I’m with jingle bells. See another dr. Get a different protocol . This clearly isn’t right. It’s a hotch potch. As the surgery admin if there’s a menopause specialist gp in your practice .

JinglingHellsBells Sat 02-Feb-19 09:17:18

@Anita6810

Using the mini pill is not necessarily giving you the right type or amount of progestogen. There has to be the correct ratio between a progestogen and the amount of estrogen.

Have you actually had a discussion with your GP and did they discuss any of this?

What's really scary is they have got the prescribing all back to front.
Oestrogen is daily and progestogen is 12 days per cycle.

Have you got the Oestrogel pack? Inside there is a leaflet which explains how to use it- and it says every day.

How can this dr be practising when they are prescribing incorrectly like this?

Lesleyslife1 Wed 06-Feb-19 20:25:35

Hi ..I have been on the Estrogel 2 pumps in the morning for 2 weeks .I'm due to start Utrogestan tomorrow 100mgs...it says to take this at night .Should I be using the gel at night too ??
Any help would be great .I've tried Femosten and patches and wanted this regime to be the one that fixes me smile..

JinglingHellsBells Thu 07-Feb-19 08:29:02

It makes no difference when you use the gel.
It builds up in your system to a constant level if used properly, every day.

Utrogestan is taken at bedtime because it has a sedative effect. Sometimes in larger doses (200mgs) it can cause short term dizziness which again is why it's used at night.

If you are using Utrogestan every day, presumably your own periods are over by 12 months? If not you should be on the sequential dose, which is 12 x 200 mgs ( 2 capsules) for 12 days each month.
The 100mg dose is for women who are post menopause and have not had a period for at least a year.

Lesleyslife1 Thu 07-Feb-19 20:43:45

Hi
Thanks for the reply .No I'm not post menopausal.I have been in peri for about 2 years .I am.47 .
Has my gp prescribed it incorrectly do you think.?

Lesleyslife1 Thu 07-Feb-19 20:44:51

Should of Utrogestan for 12 days only

Deanna409 Wed 13-Feb-19 16:18:47

I have been on Estrogel for 3 1/2 years. I take mine in the morning. I don't think it matters. However, I make sure I give it a 24 hour window before I take my next dose and I do one pump a day on alternating arms (read the directions thoroughly). I would not go over the dose you were recommended without consent of your OB/GYN. It is possible to use too much of it and get the opposite effect. I made the mistake of stopping it for about a month thinking I was fine and then went back on it without consulting my doctor and I doubled the dose thinking I'll feel better. This put me into full menopause and I suffered severe anxiety, depression and panic attacks. I missed work for a week. BHRT and HRT is no joke. Be sure your doctor checks your hormone levels and you're taking the right dose for you. Everyone is different. I had to so some experimenting with the dosage on my own to get ME back as well. I'm almost there. This will work for you!

JinglingHellsBells Wed 13-Feb-19 19:03:39

@Deana409 Maybe you are in the US not UK? Over here, it's not normal to check estrogen levels when using HRT. It's especially not so with gel because the virtue of it is that it's easily increased or decreased. over here, (sorry if you are in the UK!) the practice is to use whatever is needed to control symptoms by gradually increasing or decreasing the amount. I've not met anyone who has been advised to consult their dr before doing this ( including me.)

lisae5771 Wed 20-Feb-19 09:05:42

hi ive been taking 2 pumps of oestrogel now for 8 weeks, hot sweats, dryness and mood has lifted but my sleep and anxiety levels (these only started 18 months ago out of the blue for no reason ) are still not great. Any one else had these 2 symptoms that have gotten better with the gel and if so how long?? i only need oestrogen as i had a hysterectomy 3 years ago, Im just turned 50 . Like a few of you have said my GP is helpful but not up to speed on knowledge of HRT and menopause :-( thanks

JinglingHellsBells Wed 20-Feb-19 09:13:08

You need to try increasing the dose.

The dose is 2 pumps as a started, but the leaflet says you can use anything up to 4. Some drs start women on 4 right at the beginning especially if they are younger ( and you are still 1-2 years under the average age for last period.)

Try increasing to 3 pumps for a few weeks then to 4 if no better.

You should also try lifestyle things- daily exercise, (which is shown to help all symptoms), reducing sugar and refined carbs, hardly any booze and little caffeine.)

Some women find things like yoga and mindfulness / meditation apps can help.

Lefuret Tue 01-Oct-19 11:50:28

Hi,
I started hrt with FemostonConti and it immediately relieved my symptoms. Actually I never had symptoms before because taking pill.
I had no striking side effects excepted headaches during the 1st week.
After 15 months I got metrorragies that stopped in a few days after interrupting the treatment. Had echo and hysteroscopy, not showing any physical problem (maybe light adenomyosis ... not clear though). I was supposed not to take HRT again until I had the hystero but that was not possible due to (nightly) hotflushes causing insomnia (after 3 weeks of break). Bleeding did not come back.
Then I realised that I had started having bloating, colics crisis (qaulified as Irritable Bowel Syndrom) together when starting Femoston and asked to switch to another treatment. I was then prescribed Estalis patches which worked fine for 6 weeks after which I started (moderate but continuous) bleeding and got pelvic pain. I made a break and tried Systen patches with Utrogestan which caused acute pelvic and abdominal pain (within 2 hours) which stopped 2 hours after removing the patch. Then again another break and then starting Estrogel plus Utrogestan - no side effect but not enough symptoms relief. I started with 1 dose to gradually increase to 3 doses. Since my symptoms are only at night, I am putting the gel before going to bed. I changed sites, let it dry for quite a while, tried having a shower before but efficiency does not improve.The (new) gyno told me it can last for one months before it takes effect (but why were the alternative treatments effective as of day 1 ?)
One gyno told me that Adenomyosis explains the bleeding with Estalis; the other one says there is no relationship

My GP told me it's very hard to diagnose adenomyosis.

Read on the web that an IRM might help and that there are surgical solutions (light and heavier)
Any one having similar experience ?

Lefuret Tue 01-Oct-19 11:55:12

Actually after starting Estrogel I switch back to 1/2 and then 3/4 Estalis patch. 1/2 did not work and 3/4 again caused bleeding. I am again on Estrogel (2 & then 3 doses) for 2 weeks and 3 doses for 3 days.
Maybe I need to be more patient but this is jeopardizing my job

JinglingHellsBells Tue 01-Oct-19 14:57:40

@Lefuret Are you in the UK for this as don't recognise some brand names and also your descriptions of treatment ( ie echo- we'd say ultrasound scan.) Can't really help as don't know which HRT you were using. Not sure what your question is about gel?

Lefuret Tue 01-Oct-19 16:41:28

Hi I leave in Belgium
System is the same as Estradot I think
Estalis is a combine patch from Novartis
Femoston Conti are combined continuous pills
My question about gel is to know how long you have to use before you feel the benefits
I am a bit surprise that it would take up to one month as with pills / patches I immediately felt the effecta

Lefuret Tue 01-Oct-19 16:41:43

I mean live

Lefuret Tue 01-Oct-19 16:42:10

And system is systen

JinglingHellsBells Tue 01-Oct-19 19:12:28

If you are in peri still, it's unlikely that the benefits you had from the tablet form were due to those. More likely it was your own hormones rising and falling.

what are these? metrorragies?

You should allow 3 months to see the full benefits of any type of HRT. Most women start to feel a bit better after 2-3 weeks .

Had your periods stopped when you started HRT? You seem to have swapped products a lot between continuous (for post meno women) and sequential.

Are you using Utrogestan daily or 12 days a cycle?

JinglingHellsBells Tue 01-Oct-19 19:14:05

Adenomyosis does not cause bleeding that you can see. It's bleeding that happens in the muscle of the womb where it cannot escape- that's why it causes a lot of pain.

Barb73 Sun 13-Oct-19 17:07:59

Hi my menopause dr has just told me to put my pumps up to 4 a day. I can’t sleep and I’m so itchy and my eastrogen levels are 1250 and I’ve read this is really high!

Lefuret Sun 13-Oct-19 19:59:59

I don’t know about my periods when starting HRT. I switched from pill ( i had periods but I think they were fake) to HRT. About 8 year’s before starting HRT my previous gyno asked a blood analysis and my estrogen’s level was already dropping. Before starting HRT my last gyno asked a blood analysis baseD on which he put me on continuous HRT; after having first hesitated with sequential. Metrorragies = hemorragies, heavy bleeding like periods for > 10 days.
I did not switch that much. After 19 months I asked to change HRT because I had bloating, abdominal pain which I initially did not relate to the HRT. (Last week I saw another gyno who told me this is a known though not frequent side effect of duphaston the progestative in my 1st HRT - Femoston). I then switched to a continuous combined patch (luckily based on another progestative) and the pain stopped but I Started bleeding (moderately but continuously) after a few weeks. My gyno was on holiday and his deputy put me on Oestrogel/utrogestan continuous but I did not get any - even slight - improvement after 3 weeks; with the previous treatment I had no problem at all. When I got my heavy bleeding episode I had to stop thé HRT to have an hysteroscopy and after 3 weeks, I could not sleep any more, proof that the HRT was useful.
The situation of the last weeks became very critical and I started fearing for my job and got in search for à gyno with compétences for ménopausis which I think I found.
He made an ultrasound and confirmed I have no adenomyosis. He proposed me various options (other patch, other pill, tibolone or Selective Estrogen Receptors Modulators). He finds SERM too expensive and since I really was in a crisis situation thought tibolone would be the best at least short term and should take effect within 4-6 weeks. After 1 week I already sleep better and does not sweat every night; maybe we will reevaluate later when it will be a better time to test something else. This doctor is very friendly, explains everything and seems very knowledgeable. He his head of in a large university hospital and coordinates their menopause clinic; he is also a teacher and I guess that’s why he can explain. Also, he adjusts to the level of his patient, treats me as an adult which was not the case of the previous one

cleowasmycat Thu 17-Oct-19 13:09:10

Hi,

I've been using 1 pump of gel for two weeks but have upped to 2 pumps as i dont feel any better, Also taking progesterone tablets - two weeks on and two weeks off.

How soon should I feel better - should i increase to 3 pumps or wait?

Any advice greatly appreciated.

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