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Oestrogel: new packaging (yet again)?

1000 replies

Cosmetichamster · 12/12/2022 12:07

Hi ladies,

Just got this month's prescription for Oestrogel, and I have been issued with a bottle that is new (to me at least). Have a look at the photo: left is what I have known and used since June this year, on the right is the new bottle, also from Besins, same labels, same ingredients, and long use by date (07/25). Obtained from a reputable pharmacy, which has filled all my previous HRT prescriptions.

Has anyone seen this sort of thing? Slightly freaked out here. Shock

Oestrogel: new packaging (yet again)?
OP posts:
Thread gallery
121
Lotusflower75 · 16/08/2023 15:43

Azaleah · 16/08/2023 12:18

Yes, it's a bit confusing, but the explanation is that oestrogen works in an inverted U shaped curve, meaning you have similar symptoms when the levels are too low or too high, the sweet spot being at the medium level (the curve inflection point,).

That makes sense then why the email I got back from Besins showed a slight difference in numbers when it compared the two gels I’d reported. One was higher (the white capped) than the other (turquoise cap). I know the amounts look negligible but hormones are very sensitive to change as we all know! 🤣

Muttley47 · 16/08/2023 15:54

@Azaleah thank you for doing that. I hope they reply with something useful/helpful. I'm gutted as I felt amazing in that one bottle I had with the Belgium address of 'Avenue Louise 257' as opposed to 'Rue Wadhington 80'.

Azaleah · 16/08/2023 16:02

Lotusflower75 · 16/08/2023 15:43

That makes sense then why the email I got back from Besins showed a slight difference in numbers when it compared the two gels I’d reported. One was higher (the white capped) than the other (turquoise cap). I know the amounts look negligible but hormones are very sensitive to change as we all know! 🤣

Absolutely!

I have posted a link to a scientific article on the instablility of molecules in formulations with small amounts of estradiol as it happens to be the case with gel and patches. If anyone is interested I can post it again.

That email reply from Besins was a huge step compared to the standard ones they usually send to ordinary patients like me 😂

I have your original post and I am investigating this. The amounts aren't negligible, we are talking about milligrams which are 1,000 times higher than the micrograms we are supposed to absorb and 1,000,000 times higher than the picograms that are supposed to be effective at the cell level.

Azaleah · 16/08/2023 16:05

Muttley47 · 16/08/2023 15:54

@Azaleah thank you for doing that. I hope they reply with something useful/helpful. I'm gutted as I felt amazing in that one bottle I had with the Belgium address of 'Avenue Louise 257' as opposed to 'Rue Wadhington 80'.

You're welcome, fingers crossed.

That adress is just for what they call 'market authorisation holder' which is an office, not a lab or factory, but it's interesting that they have moved headquarters...

Azaleah · 16/08/2023 16:14

Azaleah · 16/08/2023 16:02

Absolutely!

I have posted a link to a scientific article on the instablility of molecules in formulations with small amounts of estradiol as it happens to be the case with gel and patches. If anyone is interested I can post it again.

That email reply from Besins was a huge step compared to the standard ones they usually send to ordinary patients like me 😂

I have your original post and I am investigating this. The amounts aren't negligible, we are talking about milligrams which are 1,000 times higher than the micrograms we are supposed to absorb and 1,000,000 times higher than the picograms that are supposed to be effective at the cell level.

Correction! 1,000,000,000!

JinglingSpringbells · 16/08/2023 17:19

That email reply from Besins was a huge step compared to the standard ones they usually send to ordinary patients like me

Are you in the same boat as posers here @Azaleah - using gel?

Azaleah · 16/08/2023 17:22

JinglingSpringbells · 16/08/2023 17:19

That email reply from Besins was a huge step compared to the standard ones they usually send to ordinary patients like me

Are you in the same boat as posers here @Azaleah - using gel?

I was referring to the time when I used Oestrogel (perimenopause), and my sister has been using it for 10 years, why?

Azaleah · 16/08/2023 18:33

JinglingSpringbells · 16/08/2023 17:19

That email reply from Besins was a huge step compared to the standard ones they usually send to ordinary patients like me

Are you in the same boat as posers here @Azaleah - using gel?

I have just realised you have highligthed 'ordinary patients like me'. Have you noticed the emoji (😂)? Do you know what it means?

You have posted on this thread before and you have implied that the return of symptoms was a nocebo effect, that Besins, like all pharmaceutical companies, are very strictly regulated and so on.

Now, I ask you: are you in the same boat as posters here?

Have you been given different packagings of Oestrogel and/or Oestrodose and have you felt any difference, have you had a return of symptoms?

I suppose you haven't, but the nature of this thread is to try to find the reason why some women are feeling bad on some batches of Oestrogel/Oestrodose.

If we can't find a logical explanation, then I will have to accept the nocebo effect. Until then, I will continue to investigate, even if I am not using it (thank goodness for that), for 3 reasons: I am a scientist, I am an amateur sleuth, and I feel good helping others.

Lotusflower75 · 16/08/2023 20:29

Azaleah · 16/08/2023 18:33

I have just realised you have highligthed 'ordinary patients like me'. Have you noticed the emoji (😂)? Do you know what it means?

You have posted on this thread before and you have implied that the return of symptoms was a nocebo effect, that Besins, like all pharmaceutical companies, are very strictly regulated and so on.

Now, I ask you: are you in the same boat as posters here?

Have you been given different packagings of Oestrogel and/or Oestrodose and have you felt any difference, have you had a return of symptoms?

I suppose you haven't, but the nature of this thread is to try to find the reason why some women are feeling bad on some batches of Oestrogel/Oestrodose.

If we can't find a logical explanation, then I will have to accept the nocebo effect. Until then, I will continue to investigate, even if I am not using it (thank goodness for that), for 3 reasons: I am a scientist, I am an amateur sleuth, and I feel good helping others.

@Azaleah im really grateful for your investigations. This thread is a comfort to most I’m sure - it is me- during what can be described as hell some days! Incidentally I spoke with the menopause nurse at my appointment and explained what had been going on with the gel. She said she was aware of other women reporting the same thing to her and the practice where she works. My GP said she’s also aware of this issue with women under her care reporting problems with the gel. The thing is they are just prescribing different HRT which is understandable, but this doesn’t help investigate the issue. (I’m now on a patch which I’ve had to try because the white capped batch made me feel so unwell. )

Azaleah · 16/08/2023 20:41

@Lotusflower75 Thanks lovely ☺️

That's exactly how I feel about this topic.

I spent a lot of time and effort investigating this issues when the first bouts of shortages started.

Most people who consider themselves menopause awareness advocates stopped investigating Oestrogel's inconsistencies as soon as the government and Besins reassured them they were looking into it.

I have told many women who are not feeling well on Oestrogel to try patches or Lenzetto spray, because they need to function again and maybe Besins deserve a drop in sales, but I haven't stopped investigating it.

I genuinely feel that it's very important to know exactly what you are going to use in your body for the rest of your life.

nummy2 · 16/08/2023 21:20

Thanks again to all the posters who have been doing all the scientific research.

Just to clarify- is the suggestion that the white topped cylinder shaped bottle actually has MORE oestrogen?

The way I felt within a day or two of using it was like a very sudden, out of the blue return to pre-HRT, peri-menopausal symptoms: the anxiety, irritability, low mood etc. Had previously felt great on the blue topped, conical bottle, been on 2 pumps for a couple of years and no longer have bleeding, (age 53).

Think I'll persevere with 2 pumps, rather than 3, if risk is of too much oestrogen. Feel a bit better today, so maybe things are settling down...

Azaleah · 16/08/2023 21:53

@nummy2 Not necessarily, it depends on which bottle you have been using before you got the cylindrical bottle.

We can't know if they have more or less estradiol, because the batches seem to be inconsistent, but most women have reported a return of symptoms after changing from the conical bottle with an orange square 🟧 to the cylindrical bottle with a white lid.

Maybe it has less estradiol, but it could also be an absorption issue.

Fingers crossed you will feel better soon 🤞🏻🤗

nummy2 · 16/08/2023 22:03

@Azaleah Thank you! Much appreciated xx

Azaleah · 16/08/2023 22:10

@nummy2 You're welcome! And keep us posted 🤗

Birdwithaview73 · 17/08/2023 07:31

Thank u for continuing to investigate I have spoken with my clinic and I am going to try patches estrodot though it’s cost me another small fortune. Using the end of old bottles has improved my symptoms within a day and it’s just crazy but I just can’t cope with the up and down of it all. I’m just hoping they work for me. Not sure when to apply etc but will see when they arrive hopefully today then I can ask gp to prescribe.

MargotMoon · 17/08/2023 08:00

Just wanted to make sure that everyone on here is aware of the HRT PPC which covers all prescriptions for £19.30 per year.

You can check if your HRT is covered in the link before buying (oestrogel definitely is):

www.nhsbsa.nhs.uk/help-nhs-prescription-costs/nhs-hormone-replacement-therapy-prescription-prepayment-certificate-hrt-ppc

Muttley47 · 18/08/2023 00:57

Ah OK. I'm guessing (literally) that the fact this gel is thicker and dries much faster that would potentially impact delivery of the estradiol and possibly absorption?

Azaleah · 18/08/2023 16:43

Muttley47 · 18/08/2023 00:57

Ah OK. I'm guessing (literally) that the fact this gel is thicker and dries much faster that would potentially impact delivery of the estradiol and possibly absorption?

Yes, I think it's possible.

We know thet formula and the formulation should be the same, but if some women are noticing differences in texture and smell (and that's subjective), there must be a reason.

It's subjective because I understand that most women have finished a bottle by the time they realise the new one isn't quite the same. Texture and smell are subjective sensations.

The ideal situation would be to make a video of pumping both bottles at the same time on a clean surface (perhaps against a dark background) so we can really see the resulting 'blobs'. The videomaker could ask someone who has never used the gel to smell them and give their verdict.

Unfortunately, I don't have access to the gel in the conical bottles at the moment, otherwise I would make it myself.

I was thinking about this picture (I found it when I was writing my 'article' during the shortages).

Perhaps the gel is manufactured in Drogenbos, Belgium (BMB), where the main manufacturing process takes place, and part of the gel is transported to Montrouge, France, in bulk, inside special containers.

There, Besins (LBI) could be doing what in pharma is called fill&finish, filling the bottles with gel, sticking the labels and packaging them inside the boxes.

The orange and green squares could mean 'manufacturing' and 'fill& finish' respectively.

This is just speculation, because contrary to what is said in the picture, Besins factories do not produce the active substance (estradiol).

If this is the case, something may be affecting the physical and therefore chemical properties of the gel during shipping.

Anyway, I'm quite convinced that the green square means the manufacturing site at Montrouge, France.

The UK patient information leaflets are not specific about this but in other countries the other product marketed by Besins, Testogel (in some countries it's called Androgel), comes either in sachets or pumps and they say the sachets are produced by BMB, Drogenbos, Belgium and the pumps are produced by LBI, Montrouge, France. These bottles have the green square.

That said, I would like to ask everyone:

  1. Have you ever used or seen an Oestrodose bottle with an orange square?
  2. Do you have different bottles with enough gel inside and would you be willing to make a video as described above?
Oestrogel: new packaging (yet again)?
Azaleah · 18/08/2023 20:34

'Around April 2022, pharmacies were reporting supply shortages of HRT products, particularly Oestrogel (Oestrogen gel) and FemSeven Sequi skin patches'

https://www.fertifa.com/post/hrt-shortage-and-how-to-get-hrt

Now see the NHS HRT products prices list... They're under Part VIIIA Basic Prices of Drugs. Scroll down until you find Estradiol. Oestrogel is the first on the list.

https://www.nhsbsa.nhs.uk/sites/default/files/2023-02/Drug%20Tariff%20March%202023.pdf

https://www.nhsbsa.nhs.uk/sites/default/files/2023-03/Drug%20Tariff%20April%202023.pdf

All HRT products have the same price except for Oestrogel. The same month (April 2023) that Oestrogel price rised from £4.80 to £6.17, Vagifem has been excluded from the list to be replaced by the generical Estradiol 10 microgram pessaries (much cheaper and listed as category M instead of category C which are branded medicines without a generic equivalent).

Coincidence?

Why there's no generic estradiol gel available? It's not just in the UK, it's worldwide.

Oestrogel has been marketed in France since 1974, the original patent has long gone, but it seems they keep adding 'new' features to the gel or system delivery (pump, pouch) that extends the patent indefinitely...

https://undark.org/2021/06/16/how-patent-extensions-keep-some-drug-costs-high/

Why is there an HRT shortage and what can you do to get it?

In this article, we'll explain what's behind these shortages, what to expect going forward, and how to maximise your chances of getting hold of HRT in order to get back on top of those distressing menopausal symptoms.

https://www.fertifa.com/post/hrt-shortage-and-how-to-get-hrt

Birdwithaview73 · 19/08/2023 14:50

Yes that all seems quite obvious it’s normally financial costs when they change a product. They changed me from vagifem to vagirux and it’s simply not effective as these gels. I’m not trying a patch instead of oestrogel which I’m only on day 2. Seems ok but my neck clicking and joint pain has returned and sweating quite a bit. I’m hoping it settles as an alternative. It’s nice not to have to put gel on 2 x daily on every arm and leg 😆

Azaleah · 19/08/2023 15:31

@Birdwithaview73 Yes, it takes time for the body to adjust to different HRTs, but you'll get there. Which patch are you trying? I agree that not all generic drugs are effective and that it's all about cost. Follow the money is the number one tip for amateur sleuths lol.

Coffeebutter · 19/08/2023 17:09

I got my latest prescription before hols and it was the new cylindrical bottle , finished my old one and started the new one. I IMMEDIATELY got symptoms of changed mood and proper hot flashes which I never even suffered from before.
it’s like withdrawal symptoms - as is it’s not working .
Stuck now with a gel that’s not working, called my pharmacy and told them, but they didn’t have a way of checking a difference in supply/batch. Said maybe does needed changingz
coincidence??
you would think women are crazy, but it’s definitely true, I can feel the difference !

Skinnybluebody · 19/08/2023 18:11

Birdwithaview73 · 19/08/2023 14:50

Yes that all seems quite obvious it’s normally financial costs when they change a product. They changed me from vagifem to vagirux and it’s simply not effective as these gels. I’m not trying a patch instead of oestrogel which I’m only on day 2. Seems ok but my neck clicking and joint pain has returned and sweating quite a bit. I’m hoping it settles as an alternative. It’s nice not to have to put gel on 2 x daily on every arm and leg 😆

This is literally what I'm doing at the moment except I'm on day 5. Same symptoms returned as you. Fingers crossed it settles. Also enjoying not applying 4 pumps of the gel daily though! Every cloud 😊

Azaleah · 19/08/2023 19:10

@Coffeebutter Some women also think we're crazy... if they feel fine on different versions of the gel, they say it's a nocebo effect. Perhaps we could control menopause symptoms with our powerful minds. Now that would be bad news for Besins 😂

Hartieharts · 25/08/2023 03:37

I'm new to the chat, but basically I have been using oestrogel in the older style bottle's for about 4 years. I've been going through the menopause for 6 years now. I use 4 pumps a day. The last few bottle's I've got are the newer ones with the white lid.
All of my symptoms have come back within a few days of using the new bottles. So I ring the doctors and he said to try 6 pumps. Tried it for a week and still had all the syptoms as if I wasn't taking any hormones at all. I even went up to 8 pumps and absolutely no difference what so ever.
I'm now back on the evorel 100 patches and my symptoms are better but I'm still suffering with awful heart palpitations. And the weight I had lost after being on the gel is creeping back on.

I'm really fed up with being messed about by lack of products in the beginning and now this new gel that doesn't work.

What can we do to make the companies producing it, that its not working???

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