Oestrogel pump has run out early - what's gone wrong?

[ILoveRevels]

Will have been in HRT 4 weeks next Tuesday so have 4 days left to go in pump including tonight's. 2 pumps a day and followed instructions but I think pump has almost run out. 1st pump tonight gave me a tiny squirt (drop) so I did another one which was normal then 2nd pump was probably half a pump.

It feels like there's a bit more in the bottle but can't see that bottle unscrews or if I could access it how I'd work the dose out properly.

Think I've been shorted on tonight's but have 2 more pump packs as GP prescribed 3 months supply. However if I lose 4 days every month I'm worried I will run out as prescriptions won't keep up.

Anyone else found this? What am I doing wrong?!

Thanks

Watching as this has just happened with my first bottle. Last 4/5 goes were hit and miss.

It can't just be us @Rollergirl1980 - hopefully someone will be along shortly to tell us what the knack is.

I also had this. Currently on the 3rd month.

The first one petered out early so I attacked the plastic bottle and managed to hack it open. Inside there is a silver foil bag attached to the pump. I cut the corner of bag open and there was some gel left so I just squeezed it out and estimated the dose for the last 3 days.

Second bottle lasted 29 days. I opened that one and could see and feel that the foil bag was completely empty/used

No idea why the first one stopped pumping. It is very difficult to cut into the bottle so I would not recommend it

Perhaps it was a dodgy batch??

Thank you @SecretDoor - I was contemplating attacking the bottle as I'm sure there's some gel in there still although it sounds challenging! Why don't they put a bit extra in to avoid this issue?

Maybe we should use the first pump of the bottle that's meant to be thrown away?

So, you can get a good few more out of it, but only 1 pump or half a pump at a time, because its just the dregs and it takes time to settle again. What I do is start my next one (you have to try to strategically order a few days in advance so you get room for manoeuvre) then I take one out of the old one and three out of the new one. They actually go on for ages like this and I sometimes end up with three on the go. I had a real fight on my hands because my prescription is for 2-4 pumps (doctor agreed I should use 4) but they were only allowing for the two pump amount. They do allow me to get it twice as often now thank goodness.

I can’t remember how much came out in that first discarded pump @Rollergirl1980 but yes, every drop seems precious now. I presume we are advised to throw that first pump away as the dose might note be accurate.

@GoWalkabout - that’s useful advice thank you. I was thinking of opening the next one (my GP prescribed 3 at once so presume after my review I would get 3 months supply at a time on repeat prescription) but I was concerned about losing track but your idea of mixing and matching to get the full dose while the remaining gel settles makes sense. How ridiculous that you were advised to use 4 pumps but not prescribed enough gel!

DH attacked the bottle for me earlier and inside as @SecretDoor said above there is a foil pouch which contains the gel and the pump nozzle sits in it (I had imagined there would be a tube like you get with liquid soap but there isn’t) so I’m guessing it’s some kind of vacuum method that dispenses the gel. Anyway there is a decent amount of gel left in the foil pouch so I’ve turned it upside down and squeezed the gel towards the nozzle in the hopes that this will help get the remains gel out. In theory there should be 10 more doses in the pouch! It doesn’t seem like the most efficient delivery system but I have the same problem with pump hand creams. I didn’t fancy patches though as I thought they might irritate my skin like plasters or fall off in the shower as I shower twice a day. Did consider spray - maybe that would be better?

If anyone is at all interested in seeing the foil pouch removed from the bottle let me know and I will try and post a photo.

With most prescription a month is classified at 28 days. I have several regular prescriptions for various medications and they are always done in multiples of 7.
Each bottle is probably designed to last 28 days rather than calendar months.

I have tried the spray (Lenzetto) and it was useless for me. It was easy to apply but you also got the unequal doses at the end. I'd end up spraying twice or three times to get the usual amount.

@Angrymum22

With most prescription a month is classified at 28 days. I have several regular prescriptions for various medications and they are always done in multiples of 7. Each bottle is probably designed to last 28 days rather than calendar months.

Each pump has 64 pumps, (called measures on the carton.) It's meant to last 32 days (using 2 pumps per day.)

I've never had an issue with it. I do know that by pumping the top really hard, it's possible to get smaller amounts out when you think it's empty.

Can't you just ask for the new prescription 2 weeks before you run out?

The Oestrogel is as @JinglingHellsBells says 64 metered doses per bottle so on my 2 pumps a day it should last 32 days.

I do have 2 more bottles as my GP prescribed 3 months worth to start with and presumably once on repeat I would order 3 months/bottles at a time. Not panicking but a bit disconcerted to run into difficulties dispensing on day 25. This is all new to me and I was worried about getting the dose wrong (more or less than intended).

I could order early when I need to however my practice put a repeat ordering date on when you can next order medication so if I ran out a few days early each month eventually I might end up trying to order well before the date I'm allowed to.

I'm grateful for all the helpful suggestions from everyone and also glad to know this is normal. Squeezing the foil bag and pumping seemed to work well and I think I got about the right amount. I'm sure I can discuss with my GP at my review or the prescription team if I need to - they are always really helpful.

Also, please could someone tell me you're supposed to shake the bottle at all? I didn't see that in the instructions but think I read it on another thread. Thank you!

I wish I could help you more @ILoveRevels but I've not come across this. I've used the gel for over 12 years.

I admit I don't count the exact number of days (although I always write the start date on the carton so I know when it's getting low) as I usually have 2-3 months or more in my 'stock' . sometimes I don't use 2 pumps , but more like 1and a half pumps, so a bottle lasts me about 6 weeks.

If you are worried you may not get your repeat in time, why not slightly reduce the amount? You can get half a pump out or even 3/4s out by not pressing the plunger right down.

You don't need to shake it and in fact you can't. The inner pouch is plastic and 'deflates' when it's used, so there is no air in the inner pouch.

I also find you can squeeze a few more days out by running the old and new bottle in tandem.
As the gel is thickish when there's not much left it doesn't flow to the bottom of the pump dispenser as quickly as it should, but if you can get one sqoosh out, you can go on like that for a few days, using the new bottle for second/subsequent doses.

I also had to point out to the gp that one bottle of 64 pumps (at two pumps per day) was not going to last me two months, they seemed put out that basic maths proved them wrong. ..especially as they get most vexed if you try and order anything at all outwith the eight week cycle.

I always pull the bottles apart when they run out (well, I get DH to) and I’ve found the amount left in the silver bag varies. Some of the bottles have several day’s worth in when they stop pumping out gel while others have virtually nothing in them. It’s strange!

Those of you getting your DHs to help open the bottles- I thought it was advised to keep it away from men?

My DH wore gloves while handling the bottle and was careful. The oestrogen is contained inside a foil pouch in the plastic bottle so it's very clean and dry in there. Obviously washed his hands thoroughly afterwards too.

How do you all ensure you protect others from touching the gel? I get worried as it's pretty messy (unlike the spray). I change the hand towel after I've washed and dried my hands but still worry I've left traces at the sink.

@Rollergirl1980

How do you all ensure you protect others from touching the gel? I get worried as it's pretty messy (unlike the spray). I change the hand towel after I've washed and dried my hands but still worry I've left traces at the sink.

It's estrogen not something radioactive

@Rollergirl1980 There is absolutely no need to take those steps.

The guidance is avoid skin to skin contact with another person (where the gel has been applied to your arms or thighs) for 1 hr after application.

Thanks @JinglingHellsBells!
I think I was worried because when I used the spray the instructions around contact were quite scary!!

@Rollergirl1980

Thanks *@JinglingHellsBells*! I think I was worried because when I used the spray the instructions around contact were quite scary!!

We are all exposed to estrogens in the environment far more than your H would get from anything left over in your sink!

Update: the gel has lasted really well and kept going to just past 32 days (there might even be another couple of pumps left to go). I stored the foil pouch with the cap on upside down in the box in between uses.