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Menopause

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A quick question about estrogel...

66 replies

Coffeefacescrub · 05/01/2017 08:37

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.

OP posts:
PollyPerky · 05/01/2017 10:15

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 · 05/01/2017 11:08

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

OP posts:
PollyPerky · 05/01/2017 11:18

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 · 05/01/2017 11:27

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

OP posts:
Coffeefacescrub · 05/01/2017 11:29

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?

OP posts:
PollyPerky · 05/01/2017 11:31

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 · 05/01/2017 11:33

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 · 05/01/2017 12:59

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

OP posts:
NK346f2849X127d8bca260 · 05/01/2017 13:25

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

Coffeefacescrub · 06/01/2017 11:44

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?

OP posts:
Aroundtheworldandback · 07/01/2017 22:17

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

PollyPerky · 08/01/2017 08:25

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 · 30/06/2018 12:12

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 · 30/06/2018 12:41

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 · 30/06/2018 13:31

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 · 30/06/2018 13:34

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

QueenoftheNIghts · 30/06/2018 15:42

@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 · 30/06/2018 17:41

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 · 30/06/2018 18:04

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 · 30/06/2018 18:17

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 · 30/06/2018 18:19

Phyc was a spelling error 😂😂

QueenoftheNIghts · 30/06/2018 19:26

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 · 30/06/2018 20:41

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 · 30/06/2018 20:42

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 · 30/06/2018 22:30

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 ?