Oestrogel…just one pump?

[olivo]

I’ve got a little confused with the dosage of the HRT I’ve started this week. the two bottles of gel I’ve just collected say ‘apply ONE pump to the thighs daily’. I started just a few days ago and threw out the box with the label by mistake but thought it said one pump to each thigh, which is what the leaflet suggests. Would you just spread one pump across both thighs or continue with one on each?

What did the GP prescribe? I started with one pump on each thigh, but build up gradually as it made me feel nauseous. So one pump at first for a few days, then one in the morning and one at night, then eventually two pumps in the morning.

That’s the problem, I don’t remember what he prescribed and the printed label on the first one was o nthe box, not the bottle, and I binned the box. The second and third bottle label say apply one pump to the thighs daily. So I don’t know if that means 1 pump to each thigh or one between the two. Presumably, if I cut down to just one in total, I won’t notice a difference at this stage? It seems like a low dose

I feel better already after a few a days ( but that could be placebo effect!)

One pump total would be a low dose. Call your surgery in the morning and ask if the GP can confirm the dose as instructions are unclear. The receptionist can check with the GP and call you back.

Have you not got a bottle in its own box with a label on ? My bottles are all in their own boxes.

The second and third bottles say ‘ apply one pump daily to the thighs’.I got three bottles with three months of tablets so I suppose I assumed a bottle (60pumps) per month.

I’ll try and call on Monday but I suppose I’d better cut back to just one pump for now.

Two pumps is the standard dosage, but the wording is ambiguous, so I would check to be sure.

Are the progesterone instructions clear? I got mine wrong for over two years!

Many GPs start women off on "One metered dose/pump daily" then review it after 3 months or thereabouts and increase dose if needed then. It is likely all 3 bottles had the same dose on if on the same prescription. Starting on a low dose can reduce the side effects compared to going straight in at a higher dose

Mine prescription stated 2 pumps a day, but that gave me too many side effects so I dropped down to one pump a day, which suits me fine. I think it take a little while to find the right level.

My starting dose was two pumps.
Perhaps ask at the dispensing chemist first as you’ll get through to them quicker.

@olivo There is no right and wrong amount (unless prescribed for osteoporosis, when it's 2 pumps daily.)

The leaflet gives the guide of 2 pumps per day. That gives approx 1.5mgs of estrogen which is a medium dose. (Tablets come in 1mg and 2mgs doses.)

Most women would start on 2 pumps.

However, the benefit of gel is that you can use whatever you need to relieve symptoms.

Some women get by fine on 1 pump, others need up to 4 a day (this is all on the leaflet inside- max 4 pumps daily.)

The instructions you were given are unclear as they should have said one pump to EACH thigh daily, unless there is a reason why you should use 1 only.

I'd suggest you carry on with 1 pump and see how you feel. If your symptoms don't improve, increase your dose.

The patient leaflet in the pack has all the information or you can find it all online by just searching for the product.

Thanks all. Definitely clear for the progesterone…25/28 days, one tab each of those 25days. In my head, it started working right away so I suppose I am worried if I go down to just one pump between two thighs, I won’t feel a s good, even though it’s been less than a week! I have had no negative side effects at all luckily.

I was prescribed two pumps but I only do one as I think it makes me extremely itchy.

Hi.
I’m about to embark on my oestrogel mission and wondered how you were getting on? I’ll be starting on one pump to see how it goes.
can I ask.. do you start first day of your period?
many thanks in advance X

One pump is a very low dosage. Most start with 2, and then increase if necessary.

To be clear - you're taking progesterone tablets 25 days out of every 28?

2 pumps would last a month.

Yes, progesterone 25 days out of every 28 (plus mini pill). I have been doing 1 1/2 pumps as an easy medium and all ok at the moment. I had to ask for a repeat rather than visit for an appt so no opportunity to discuss the dosage as yet.

Your pharmacy will have the dose on your record as well, might be easier to check with them. But 3 bottles for 3 months is 2 pumps per day.

ive had the prescriptions from two different pharmacies. Presumably, they just have the same info as on the label? If two pumps is considered normal, I feel reassured that my 1 1/2, even if not enough, is safe. I feel great since starting HRT!!

There is no right or wrong here about dosage.

@olivo It's what suits you best.

The medical advice for ALL HRT is the lowest dose to control symptoms.
(This applies to patches, tablets and gel.)

Many women start too high- on 2 pumps- and get some side effects. I was advised by my consultant to start low and work up to the dose that worked for my flushes/ insomnia. I started on half a pump and eventually settled on 2, for years.

I've changed the dose over the years ( more than 12.)

I am (mainly) symptom free on 1 pump but my consultant advises me to use 2 pumps as this is the dose for bone density protection, and that is one of the reasons I'm using it . I have noticed night sweats creeping back on 1 pump if I use only that for weeks/months.

It's not 'wrong' or 'dangerous' to use a different dose to anyone else. The leaflet says try 2 pumps and work up to 4 if necessary, but this is just what suits the average woman rather than being tailored to her symptoms and needs.

Also @olivo the 25/28 days for Utrogestan has been updated by menopause specialists who suggest using it every day.

This brings it into line with all other combined continuous tablets and patches.

The 3-day break (in the leaflet) was / is to allow for a very light bleed if it was to happen. The majority of women on combined continuous don't bleed on the 3 day break, which is why it's been replaced by medical practice, even though the leaflet is behind the times.

Thanks Jingling, I was intending to ask about. The full 28 days but
I had to cancel my appt due to Covid and ask for a repeat instead, I will go back after Christmas and hopefully get the 28/28 Now that you have clarified that.