changing from patch to estrogel

[ladygindiva]

Hi hoping some of you knowledgable ladies are about to help. I've had my prescription changed as me and the gp decided i needed more estrogen but cannot continue with the patches I was on ( evorel sequi) as apparently they don't come in a higher dose than 50 mcg estradiol , so I've been switched to Estrogel 750mcg / actuation gel and directed to use one pump daily which I believe gives me 0.75mg or 750mcg of estradiol?? Am I thick or is the maths way off? I've been sat with a calculator trying to make sense of it all. Help!!
Also; should I rip off my existing patch and start smearing this on right away or wait until tomorrow; and is there any better time of day to apply?

It's not possible to compare patches which release the product over several days with other types of hrt in the way you are trying to.

I think Dr Louise Newson had a 'convertor' on her website when some hrt was in short supply, so women could change to something else. You might want to google or search her site.

What I can tell you is that 50mcg patch is roughly the same as 2 pumps of Oestrogel (giving 1.5mgs of estradiol.)

A 37mcg patch is roughly 1mg estrogen.

If you are swapping, what are you using for the progestin part of the cycle? You will need something if you are doing away with the combined patch for half the month.

I'm just thinking that's hell of an increase

Thanks for your response ! I have utrogestan tablets to use for 12 days of my cycle and I'm all good with how to use those but I'm still confused. I'm quoting the actual medical companies information and they say that an evorel 50 patch releases 50 microgrammes of estradiol in 24 hours. And my new estrogel pump says on the side , quote, " each dose ( 1 pump) contains 0.75mg of estradiol" 0.75mg converts to 750microgrammes !! I'm confused ! I wanted an increase but that's drastic! I'll head over to louises website and look at the converter, I must be going wrong somewhere!

Estradot is a patch which gives 75mcg over 24hrs.

It is a more expensive patch I was told and I believe some GPs are reluctant to prescribe beside of this. However if you like using a patch and find it easier to stay on it you may be worth asking for this instead?

For info it's also a lovely size - much smaller than the brand you are currently using even as a 75 dose.

It's not. They are different products, I've just checked on Dr Newson's website- the page is there under INFO if you search for types of hrt/ doses.

It says 50mgs estrogen patch = 2 pumps gel.

Patches give a continuous supply over several days. Gel gives a 'boost' and is fully absorbed within an hour.

Thanks, I'm going to give the gel a go, as I kind of like the idea that if the increase is a mistake I can reduce or increase without the need for a new product so I'm really hoping I will get on with it. I also like the idea of the utrogestan as I've heard those of us with an intolerance of synthetic progesterone get on with it better?

A patch releases the product continuously.
An application of gel is different.

Tablets are 1mg or 2mgs taken daily.
If you were put on a 2mg tablet of estrogen, that would still be less than 2 pumps of gel.

Ah thanks Jingling. So I guess the 50mgs that was being spread over 3/4 days is now at two pumps being spread over 2 days so I am having an increase of sorts, 50% to 100% depending how you look at it ( maths not my strong point!!)which is what I wanted.

sorry- ageing brain- 2mg tablet is MORE than 2 pumps of gel.
Gel is 2 pumps, or up to 4 daily.

But 1 pump of gel daily is still a slightly higher dose than my evorel 50 patch? Sorry another ageing brain here!!!

You can't compare in the way you are trying to.

50mcg patch = 2 pumps of gel.

@ladygindiva

But 1 pump of gel daily is still a slightly higher dose than my evorel 50 patch? Sorry another ageing brain here!!!

No.

1 pump of gel is low dose and below the starting dose of 2 pumps, suggested on the leaflet.

In the nicest way possible, you are over-thinking. Go by the accepted equivalents shown on medical sites.

But the whole reason the gp gave me the gel was so I could have an increase on my evorel 50 patch! Shes directed me to use one pump! Has she fucked up , is this a smaller dose? AAAAAARRRRGGGHHH

sorry frustrated. Its taken me the best part of a year to get to this point, and every single step has been complicated and difficult.

@ladygindiva

But the whole reason the gp gave me the gel was so I could have an increase on my evorel 50 patch! Shes directed me to use one pump! Has she fucked up , is this a smaller dose? AAAAAARRRRGGGHHH

Basically, yes, she has. No surprise if you read all the stuff here that GPs do.

Fucks sake, so what am i supposed to diagnose and arrange my own dose?? Jesus fucking christ. She had to ring me back the day following my appointment so she could go and read about hrt treatments as she had no clue when I had my appt. My issue was needing an increase and shes actually prescribed me a lower dose. FFS. I am so angry. Thatll be the rage.

Go to My Menopause Dr and look up 'HRT- ingredients, brands and strengths available'.
There is a chart with the doses and how they compare.
Side bar with the equivalent of a patch / gel doses.

Thanks Jingling; if I hadn't popped on here I would have merrily put one pump on a day then in a few weeks probably wondered why I felt even shitter than before. I can't take much more of this. NHS menopause care is fucking shite.

Start on 2 pumps, try for 2 weeks or so, and if it works for you, great. If not, increase to 2 and a bit or 3 pumps and see if that helps. The idea of gel is not that it's stronger but you can adjust it to get symptoms-relief.
Sorry your GP is so useless.

problem is , i have one bottle that says it contains 64 pumps. I guess I'll run out soon then, and what if they don't prescribe another?

actually youre alright I've got my evorel 50 patches unused in the cupboard; I'll slap two of those on!

Rang yet another gp and he's confirmed I should be on at least 2 pumps. He sounded more knowledgeable and he said to make an appointment with him in 3 or 4 weeks to discuss how the two pumps are going and get another prescription of oestrogel. Quite a journey this. I'm so tired.

Hello, new on here, really interesting thread.
I’m wondering if someone has some advice, or knowledge on hrt strengths.
i was taking evorel conti patches 25mg, (was 50mg I cut in half.)
I was on them for around three months, and cut them again, and was informed waste of time taking them, for amount I was taking.
I feel like symptoms back, sweats, now palpitations, anxiety, sleep, headaches.
just started taking progesterone tablet, and oestrogel, 2 pumps.
Still not feeling great, wondering if to lower dose, 1 pump, any suggestions extremely grateful, I’m 62

Hiya , do you mind me asking why you reduced your dose twice ? If I haven't misread it sounds like you did.

Hello, nurse practitioner suggested to cut in half, then I cut third off.
I wasn’t fully happy taking hrt, with bad press, and my age, read over 60 not recommended, hrt