Estrogen gels - any things I should be aware of?

[didireallysaythat]

I'm fairly sure I'm pre-menopausal on the basis of my age (49), my broken sleep (hot but not crazy sweats) and my mood swings. I've just booked an apt to get my coil replaced (after 4-5 years) and had a good chat to GP about options. I had the blood test (understanding that false negative possible but false positive less so) and that suggests menopause. So the plan is get a new coil and then estrogen gel.

Is there anything I should be prepared for with the gel? Are there different ones? Should I expect an improvement in symptoms and if so how long does take? I'm sure my GP will give me more info, but he's not gone through it himself so I'd appreciate advice from first hand experience.

useful info
Is your coil the Mirena?

I'm on oestrogen patches but I'm thinking about asking to try the gel, as the patches that I can finally get hold of (whole other thread) keep peeling off.

So I'll be watching with interest.

do you grt the gel from the doctors

@slipperywhensparticus

do you grt the gel from the doctors

Yes, if you are in the UK. If you still have your uterus, you would need a progesterone element as well.

Btw, OP, I had immediate improvement in symptoms on HRT patches

I have mirena with gel, it’s been very good for me. Calmed my symptoms to give me a more even keel to work on the other things to support like more exercise and healthier eating. I really struggled with brain fog, lack of energy, hot flushes just feeling utterly crap. It’s not a magic wand but it’s made my life manageable again. I started on 2 squirts, after a year upped to 3 squirts and now I sometimes use 4, which my GP advocated. That’s the maximum dose for me though so I work hard on the other bits too with yoga, swimming, running etc to balance me. I’ve been using it for 3years now.

I was allergic to the patches which I was prescribed first and I prefer to use the gel as the risk factors were lower.

I've used gel for 12 years OP and it's great. No sticky patches on show or to change and the best bit is you can adjust the dose to get the results you want.

I use Oestrogel (there is also Sandrena in sachets) . It was suggested by my gynae consultant/ world meno expert, as being the best stuff rather than pills or patches.

I'd suggest you start low- his advice to me- with one pump and see how that works for 2-3 weeks. If you still have symptoms, go to 2 pumps and see if that improves things.

The 'starting dose' is 2 pumps but some women find it too much (I felt sick with that amount all at once to start with.)

@TriSkiRun99 There is no difference in risk between patches and gel. (which risks were you meaning, was out of interest?) Transdermal- through the skin - is safer re. blood clots than pills, but in terms of other risks, gel and patches are the same.

I had a similar experience to @JinglingHellsBells when I waded straight in with the 2 pumps. So I backed off to just half a pump (as best you can judge that) and then built up from there over a few weeks.

@TriSkiRun99

I have mirena with gel, it’s been very good for me. Calmed my symptoms to give me a more even keel to work on the other things to support like more exercise and healthier eating. I really struggled with brain fog, lack of energy, hot flushes just feeling utterly crap. It’s not a magic wand but it’s made my life manageable again. I started on 2 squirts, after a year upped to 3 squirts and now I sometimes use 4, which my GP advocated. That’s the maximum dose for me though so I work hard on the other bits too with yoga, swimming, running etc to balance me. I’ve been using it for 3years now.

@TriSkiRun99 could you possibly be affected by this: www.menopausedoctor.co.uk/menopause/oestrodose It came to mind as it sounds like your symptoms aren't controlled as much as you like. I had Oestrodose at the start of lockdown and so many of my crappy symptoms came back and I thought I was going mad! I'm back on the oestrogel now and finding it much better.

more oestrodose vs oestrogel info

Pictures of the oestrodose bottles (left) and oestrogel (right)

Ooh that’s really interesting * DiscontentedWoman as that’s the same brand I have and I noticed the bottle switched but didn’t twig it could be a variation. I’m off to check my supplies. Thanks

@DiscontentedWoman @TriSkiRun99 Just to ad my own experience to that debate....

I've used estrogel for 12 years.

I get Oestrogel at the London clinic (my consultant's practice based in a hospital) with no problem from their pharmacy. But if I need a prescription between seeing him I get it at a local pharmacy to me- and then it's always Estrodose. Even though I pay for the items (it's a private prescription) the local pharmacy cannot usually source Oestrogel even though I ask for it.

The reality therefore is that for usually half the year I have one, and half the year I have the other!

I have noticed no difference at all in 12 years.

I did bring up the topic with my consultant (he is considered on the best in the UK and women come from overseas to see him) and he says there is no difference at all and it's women's perception, not based on science.

Legally, there cannot be a difference because of quality control.

@DiscontentedWoman The photos you show are surely the same bottle but with a front and back view?

In the UK they sometimes use a new label to cover the DOSE sign and change it to Gel.

My bottles of Oestrogel look nothing like the ones in your photo- it's straight sided bottle.

My bottles of DOSE look like your photos!

Oestradose is a parallel import, and although both are manufactured by Besins, Oestradose is supplied to pharmacies from other companies and therefore does not stay under Besins' strict control.

I don't think this is right.

I have a friend who has contacted Besin's about this. She had many emails in reply.

What they say is that the inner pouch of the gel is made in their factories and it is only packaged in the rigid outer pump somewhere else as 'dose'.

@JinglingHellsBells I've never had a straight sided pump, that's interesting. Manchestermenopausehive has info on Insta about this (the bottles look like mine) and I can see a straight sided bottle like you describe in a post from drmenopausecare. My pharmacist now uses the pip code for oestrogel for me.

When I peel off the paper sticky label on the bottle on the left, it reveals the oestrodose manufacturers label underneath.

hahaha- interesting @DiscontentedWoman !

So, what you think of as 'gel' is in fact 'dose', but with a UK label stuck over it. That for me, is Estrodose, the one I get from a local pharmacy.

That is because in Europe the default product is 'dose' and for the UK market they label it 'gel'!

The gel that I get, called 'Gel' is like this bottle but with slightly different text on the bottle.

You aren't getting Oestrogel at all, you're getting Estrodose.

www.estrogel.com/- this is the gel type of container.

How long is it since you got yours? The box in the background is the same as my Oestrogel, but the Estrodose is in a carton with a pump like yours (and a different box.)

I've not had a prescription since around May/June.

Mine is from July with the correct pip code so I'm confident it is oestrogel 😊 if you have Insta you can see both types of packaging for the oestrogel.

Having read the email chain from a friend where she corresponded with Besins for a long time on this, I am inclined to believe that whatever the shape of the bottle and the label/ label stuck on a bottle over a label, it's the same stuff (I think your bottle and the label stuck on it proves the point.)

From a quality control perspective, Besins cannot have their name on it was a manufacturer if the product in the bottle is different according to the site of manufacture. I have another friend who works in quality control in the pharma manufacturing industry and this simply is not allowed to happen- controls are very, very tight and any company flouting the regulations would be committing fraud.

why would anyone put photos of estrogel on Instagram ?

No, I don't use insta.

If you read the feature on the Liz Earle site (it's written by a journalist not actually Dr Newson) a lot of it is speculation.

The speculation is that the product could have 'degraded' in its journey from France. As the gel is in a plastic inner pouch, then a rigid plastic container, then a cardboard box, and there is a mx temp guide on it, all highly unlikely.

@didireallysaythat sorry your thread has been hijacked and I'm guilty of adding to that! :(

Dear everyone

Thank you ALL for sharing your experiences and the differences or not between packaging etc. I feel so much better informed and optimistic that I might be able to take the first steps towards taking back control.

Any other tips? I've been looking at gel packs for pillows to try and help with the hot hours in the middle of the night but perhaps the gel will make everything better from the get go? I'm trying to improve my diet and up my exercise and I'm not eating crisps right now