Oestrogel: new packaging (yet again)?

[Cosmetichamster]

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.

@Hartieharts Poor thing, same here, 8 years postmenopause and had perimenopause symptoms for 10 years before that. But I had 40 years of very heavy and long periods every month, they used to last 8 days! And in peri they sometimes happened twice a month... It's the only good thing about menopause, really! 🤗

slightly off topic, but does anyone know if you can mix modes of taking utrogestan?
I take it orally, but was told I could try vagianlly. Didn’t love it, but as you are not supposed to eat 2 hrs before taking it at bedtime I sometimes wish to swap around if I’ve had an evening snack….
wonder if it will mess up the body or will the uterus be happy as long as it gets a hit locally ….

You can certainly mix @Coffeebutter

The idea of of an empty stomach isn't necessary either. The reason for that (and it may be in the leaflet somewhere) is that taking with food 'increases the bioavailability'. what that means is the effect is stronger. In some women this may make any side effects more noticeable (especially drowsiness.) But it makes the drug more powerful, not less.

You can mix vaginally and orally. I do this sometimes because after several days of vaginal use I get a bit of irritation.

I don't know if this has been mentioned anywhere in this thread, but Besins are well aware of the situation and are in the process of building a new site on 9 acres of land acquired for this.

I found this on some info by Dr Newson where she had interviewed them about the shortages of Utrogestan.

Obviously this is a longer-term plan.

I am so glad I have found this thread. The packaging on my prescription has also recently changed.

I didn't think anything of it, but over the last couple of months my symptoms are back – in particular, the lack of Deep Sleep and the anxiety. I saw the doctor and I am now trying four pumps instead of three. This is the first week so I can't really report any changes but I wonder if the return of symptoms is due to a change in the formula in some way.

@Crinklecutchips1 That's what happened to me and after that the symptoms came flooding back like I was not taking HRT at all. As I said in a previous post I even went up to 6 pumps and the 8 after that. I struggled for over two months. I finally gave in and went back to patches, which are not the same as the gel.

Hi @JinglingSpringbells do you mean they're aware if return of symptoms and change in manufacturing if Oestrogel? Or just that they're expanding to make more Utrogestan?

@Hartieharts - in what way are the patches different from the gel? I am considering switching as I haven't slept for 4 nights in a row (past 4am) and losing my mind now..

@JinglingSpringbells thank you

@SoftPillowAllNight I still get symptoms with patches and I'm on the evorel 100. Mainly not sleeping and heart palpitations. With the gel I had no symptoms and sleep was not an issue.
Patches for me also kept the weight on , when I swapped to gel the weight came off.

Just to illustrate the problems with Oestrogel through a comparison with the recent shortage of Utrogestan.

This is the main reason why Utrogestan's stock is low, not because of menopause awareness and the increase in the number of prescriptions.

Besins Manufacturing Belgium is no longer authorised to do the primary packaging of Utrogestan capsules (see Clarfying remarks in the second pic attached), therefore the manufacturing and primary packaging are being carried out by a third-party CDMO, Cyndea Pharma in Spain.

The constant problems with change of packaging and shortages of Oestrogel have the same root: change of the manufacturing authorisation holder, changes in the team(s) responsible for the manufacturing process(es), changes at the primary packaging supplier(s).

My theory is that this is affecting the final product quality and although Besins has carried out tests saying the amounts of estradiol in different batches are within the expected range of 57.0 to 63.0mg/100g of gel, they haven't mentioned the amounts of ethanol, carbomer, trolamine and purified water, not to mention the different pumps and pouches.

@Azaleah will that affect the product in all countries? Yes I'm wondering selfishly if I'm going to start experiencing problems in France, but also thinking about whether some people in desperate situations can get some from abroad. Some people are clearly really suffering and patches not helping.

@Mayflier You're not being selfish at all, it's a real concern when it affects your physical and mental health.

I can't say it's going to affect supplies in France or other countries because the HRT market in the UK is unique due to many different factors (NHS price policies, menopause awareness, Brexit), but I have already posted that Besins is currently setting up a facility in Spain, and they also have one in Russia that manufactures Utrogestan (but the war with Ukraine could be a problem), so it's possible that you won't have problems buying Oestrodose and Utrogestan in France.

I don't know how the public healthcare system works in France regarding medications , do you know?

HRT for menopause is not wholly covered by the French healthcare system. Apparently the cost of one bottle of Oestrodose and a 30 pill box of Progestan is about €10 (3,99 for the progestan and €4,92 for the oestrodose plus a euro pharmacy charge). Does that match UK prices? The healthcare system reimburses 65% so I guess women like me are paying €3,50 a month. The reason I don't notice is because I have insurance that picks up the remaining cost of any treatment that is not 100% covered by the healthcare system so I never actually see a bill or pay anything in the pharmacy.

I know that Macron wants to ensure that France produces more of its essential medicines and not be too dependent on producers in other countries as France went through lots of shortages partly because the government keeps prices relatively low because the healthcare system policy is to reimburse patient costs at a higher rate than many other countries (still not the NHS obviously!). As such it's not an attractive market for producers.

This thread has made me very appreciative of having exactly the same product/bottle for 15 months so really hope it stays that way.

Thank you Azaleah. 👏

You're welcome gabbyaggy.😊

@Mayflier Thank you. The current price of Oestrogel + Utrogestan for the NHS is £12.77 or €14.92. I don't know if the prices can be compared though, as you said the systems are completely different.

I think I mentioned this before... Besins was one of the French pharmaceutical companies that joined Macron's project to move their production back to France, the name of the project was Oestro92, Oestro for Oestrogen (gel/dose) and 92 it's the zip code for Montrouge, but apparently it didn't work out.

https://www.lauriannerossi.fr/en-circonscription/visite-des-laboratoires-besins-je-soutiens-leur-relocalisation-industrielle-a-montrouge/

I’ve gone downward spiral today been using the newer shaped white top one a week or two now and it’s like a bombs gone off. Sleeps been awful , hot flushes and anxiety which I’ve never encountered before.

There have been long-running threads on this on Menopause Matters forum with mixed experiences. As many women saying no difference as those saying they have experenced some.

The only way to really check the difference is to keep a bit back of the 'old design' and get someone else to put the gel in your hand without you knowing which is which! (Blind trial.)😁

Up your dosage when using the newer cylindrical one. I had the same issue so increased from 2 pumps to 2.5-3 pumps and my symptoms went away again. When I went back to the old bottle shape, I was able to revert to 2 pumps with no change in symptoms. But now I have one of the newer bottles again, so had to go back up to 2.5 pumps as I was becoming weepy and depressed. There is definitely a difference between the two bottles. (I raised a yellow card and was told no difference but that's bs).

@JinglingSpringbells
I think because I went from old bottle to new, that how I could tell it wasn't working. Within 5 days I started not sleeping as well, then I had a complete panic attack meltdown at work over losing £40. Heart palpitations came back and then I started bloating. I have a fit bit and my heart rate was going mental at night when i used to get most of my symptoms before starting HRT. I stayed on the new gel for 2 months, before resorting to patches.
I think if your symptoms are milder the new gel has enough estrogen. But if like me your on 4 pumps a day you notice the change within a few days.
Everyone has different and varying symptoms and some of the HRT available suits some people and not others.
I've tried nearly everything there is and the old style gel was brilliant.

I would gladly do the test on old and new style I could tell you within a week the difference.

@Hartieharts - I am exactly in the same boat as you. On 4 pumps so nowhere to go when the new gel fails.

My lovely GP kindly gave me a new prescription so I could go around hunting for the conical bottle. I couldn't find it anywhere but found oestrodose instead (same conical bottle). I've taken the gamble (what choice do I have!) and hope this works. It looks/smells closer to the oestrogel conical version than cylindrical version so fingers crossed.

Please can someone tell me they have still found the conical oestrogel recently (so I don't lose hope of getting it again).

It’s full of bubbles and cloudy and runny a very consistently it’s degrading. I already upped the dosage I’ve compared it with a green top one I’ve flagged. I might as well be rubbing water on my skin using the white top one I’ve got.
I have a friend that has a pharmaceutical background and this is a contaminated batch that has passed without quality control random tested and has slipped through. In all honesty I believe this batch should be recalled.

I have just got my new prescription- a mixture of conical and cylindrical bottles. Will start a new conical bottle on Tuesday and look out for any differences

Omg, the difference in the gel is insane. I was using the green lid with green square and was transformative for me, since going on the new bottle with yellow square all
my symptoms are back! Is there any way to get the green square gel does anyone know? I find the gel with the green square is a lot former and smells a lot more like alcohol